Method and apparatus for computerized surgery
First Claim
1. An implant for use in spinal surgery comprising:
- a resilient element having an inflatable cavity, said resilient element being formed of a biologically compatible material and being arranged for placement between end plates of adjacent vertebra.
6 Assignments
0 Petitions
Accused Products
Abstract
An implant for use in spinal surgery comprises a resilient element having an inflatable cavity. It is formed of a biologically compatible material and is arranged for placement between end plates of adjacent vertebra. The implant may also include a wound disc replacement element. A method of performing spinal surgery on a patient comprises securely mounting a patient onto a patient support table; imaging a spinal region of the patient; building up a three-dimensional image file of the spinal region of the patient; storing the image file; and utilizing the image file for planning and carrying out computer controlled spinal surgery on the patient utilizing the implant. A computer-controlled surgical implant system comprises a steerable endosurgical implanting assembly operative to install the implant at a desired location in a patient; and a computerized controlled, which operates the steerable endosurgical implanting assembly.
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Citations
513 Claims
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1. An implant for use in spinal surgery comprising:
a resilient element having an inflatable cavity, said resilient element being formed of a biologically compatible material and being arranged for placement between end plates of adjacent vertebra. - View Dependent Claims (2, 3, 4, 5, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 113, 128)
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2. An implant for use in spinal surgery according to claim 1 wherein said resilient element comprises an inflation valve operatively associated with said inflatable cavity, which permits inflation of said cavity to cause said resilient element to be in an inflated state and subsequent sealing of said cavity to retain said resilient element in said inflated state.
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3. An implant for use in spinal surgery according to claim 2 wherein said resilient element comprises an inflation conduit communicating with said inflation valve and extending outwardly thereof at least to a periphery of said end plates
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4. An implant for use in spinal surgery according to claim 1 wherein said resilient element comprises a plurality of lateral projections for engagement with a disc replacement coil.
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5. An implant for use in spinal surgery according to claim 1 also comprising a disc replacement coil lead wound about said resilient element.
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55. An implant for use in spinal surgery according to claim 1, wherein said resilient element comprises at least one generally bandlike peripheral protrusion having peripheral edges.
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56. An implant for use in spinal surgery according to claim 55 wherein said peripheral edges are undercut.
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57. An implant for use in spinal surgery according to claim 55 wherein said at least one protrusion comprises two discrete protrusions.
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58. An implant for use in spinal surgery according to claim 1, comprising an implant portion which extends to the periphery of the end plates and enables injection of body substances earlier removed from a nucleus pulposus to the region between the end plates.
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59. An implant according to claim 1, also comprising at least one disc replacement band.
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60. An implant according to claim 59, wherein said at least one disc replacement band has an overall configuration generally corresponding to a peripheral edge of said inflatable implant.
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61. An implant according to claim 59 wherein each of said at least one disc replacement band is formed with an aperture on an outer facing side surface thereof, for engagement by a tool.
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62. An implant according to claim 59 wherein each of said at least one disc replacement band is formed with retaining sockets at an inner facing side surface thereof.
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63. An implant according to claim 59, wherein each of said at least one disc replacement band is formed of mechanically suitable, biologically compatible elastomer and includes at least one of a fiber reinforcing layer and at least one compression wire.
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64. An implant according to claim 59 wherein each of said at least one disc replacement band is a solid band having respective top and bottom peripheral protrusions of generally partially circular cross-section and inner and outer side surfaces which are respectively concave and convex.
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65. An implant according to claim 59 wherein each of said at least one disc replacement band is a solid band having respective top and bottom peripheral protrusions of generally partially circular cross-section and inner and outer side surfaces which respectively bear a peripheral undercut protrusion and a peripheral undercut socket, having undercut top and bottom edges.
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66. An implant according to claim 59 wherein each of said at least one disc replacement band is a solid band having respective top and bottom peripheral protrusions of generally partially circular cross-section and inner and outer side surfaces, said inner side surface being formed with a peripheral undercut socket.
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67. An implant according to claim 59 wherein each of said at least one disc replacement band is a solid band having respective top and bottom peripheral protrusions of generally partially circular cross-section and inner and outer side surfaces which respectively bear peripheral sockets, having undercut top and bottom edges.
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68. An implant according to claim 59 wherein each of said at least one disc replacement band is a hollow band having a void and having respective top and bottom peripheral protrusions of generally partially circular cross-section and inner and outer side surfaces which are respectively concave and convex.
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69. An implant according to claim 59 wherein each of said at least one disc replacement band includes recesses formed at two facing inner side surface locations which are adapted to receive corresponding protrusions of said inflatable implant.
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70. An implant according to claim 69 wherein said recesses include a generally concave inner side surface and a generally convex outer side surface,
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71. An implant according to claim 69 said recesses being defined by a tapering surface, which terminate at an inner surface.
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72. An implant according to claim 69 wherein each of said at least one disc replacement band is formed with an aperture on an outer facing side surface thereof, for engagement by a tool
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73. An implant according to claim 69 wherein each of said at least one disc replacement band is formed with retaining sockets at an inner facing side surface thereof.
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74. An implant according to claim 69 wherein each of said at least one disc replacement band is a solid band having respective top and bottom peripheral protrusions of generally partially circular cross-section.
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75. An implant according to claim 69 wherein each of said at least one disc replacement band is formed of a mechanically suitable, biologically compatible elastomer and includes at least one of a fiber reinforcing layer and at least one compression wire.
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76. An implant according to claim 55 wherein each of said at least one disc replacement band is formed with two injection conduits for injection thereinto of a flowable polymer.
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77. An implant according to claim 55 wherein each of said at least one disc replacement band is formed with a generally U-shaped cross-section defining a slightly convex outer side surface and generally flat top and bottom surfaces, defining inwardly facing edges having a cross-sectional curvature which matches the configuration of peripheral edges of said inflatable implant.
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78. An implant according to claim 55 wherein each of said at least one disc replacement band is configured at top and bottom surfaces thereof with apertures distributed along the circumference of the band, whereby flowable polymers, injected into spaces between adjacent bands and between said inflatable implant and a band, flows outwardly through said apertures into undercut recesses in said end plates.
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79. An implant according to claim 55 wherein each of said at least one disc replacement band is configured with outer facing top and bottom corner edge recesses as well as apertures distributed along the circumference of its side surface.
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80. An implant according to claim 55 wherein each of said at least one disc replacement band comprises generally flat top and bottom surfaces defining inwardly facing edges
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113. An implant for use in spinal surgery according to claim 1 wherein said resilient element comprises a pair of generally planar surfaces and a peripheral edge surface, which are configured to correspond to the configuration of a corresponding recess formed in at least one end plate for secure seating therein, optimization of distribution of pressure and forces thereon and shock absorbing.
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128. An implant according to claim 1 having an overall wedge shaped configuration.
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2. An implant for use in spinal surgery according to claim 1 wherein said resilient element comprises an inflation valve operatively associated with said inflatable cavity, which permits inflation of said cavity to cause said resilient element to be in an inflated state and subsequent sealing of said cavity to retain said resilient element in said inflated state.
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6. An implant for use in spinal surgery comprising:
a disc replacement coil, said disc replacement coil being formed of a biologically compatible material and being arranged for placement between end plates of adjacent vertebra. - View Dependent Claims (7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 119, 125, 127)
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7. An implant for use in spinal surgery according to claim 6, also comprising a resilient element having an inflatable cavity, said resilient element being formed of a biologically compatible material and being arranged for placement between end plates of adjacent vertebra interiorly of said disc replacement coil.
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8. An implant according to claim 7 wherein a seat element is seated in a recess formed in said resilient element, said seat element defining a generally circular inner recess, which defines a bearing race and retains therein a plurality of balls, thus defining a bearing.
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9. An implant according to claim 8 wherein said seat element defines an outer recess which corresponds to said recess formed in said resilient element and also defines an outer flange which rests against a surface of said resilient element.
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10. An implant according to claim 9 wherein a circular sprocket is rotatably seated in said outer recess of said seat element in bearing relationship with said balls in said bearing race.
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11. An implant according to claim 10 wherein said circular sprocket includes an underlying bearing race defining a circular recess, an inner circular array of outwardly facing teeth, which is engaged by a toothed drive belt and an outer circular array of outwardly facing teeth, each of which is formed with a transverse recess.
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12. An implant according to claim 11 wherein said outer circular array of outwardly facing teeth drivingly engages a correspondingly configured upstanding disc replacement coil for winding thereof.
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13. An implant according to claim 11 wherein said sprocket also includes an overlying bearing race defining a circular recess which retains therein a plurality of balls, thus defining a bearing.
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14. An implant according to claim 7 wherein said resilient element comprises a slightly curved generally planar, oval-shaped cover portion which corresponds in shape to a machined configuration of an adjacent facing plate of a vertebra, for secure seating therein and optimized distribution of pressure and forces thereon and shock absorbing.
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15. An implant according to claim 14 wherein an outer surface of said cover portion includes a slightly curved generally planar surface, first and second elongate edge surfaces and a curved edge surface, said edge surfaces being joined together so as to define a continuous peripheral edge surface and being joined with said planar surface in a generally seamless manner to define a smooth outer surface of said resilient element.
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16. An implant according to claim 14 and wherein said cover portion is formed with a generally circularly ring-shaped bearing race, defining a recess at an inner facing surface.
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17. An implant according to claim 14 also comprising a base member which underlies said resilient element and which corresponds in shape to a machined configuration of an adjacent facing plate of a vertebra, for secure seating therein and optimized distribution of pressure and forces thereon and shock absorbing.
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18. An implant according to claim 7 also comprising first and second generally oval ring-shaped recesses formed in a surface of said resilient element.
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19. An implant according to claim 7 also comprising a rigid peripheral band formed at peripheral surfaces of said resilient element and which is secured in a peripheral recess.
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20. An implant according to claim 7 also comprising a seat element having a circular array of bearing roller retaining recesses and corresponding cylindrical bearing rollers which are disposed on an inner surface of an outer recess and having a central recess, located interiorly of the circular array of bearing roller retaining recesses.
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21. An implant according to claim 20 also comprising a second sprocket having a motor which provides rotation of outwardly facing teeth.
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22. An implant according to claim 21 wherein said outwardly facing teeth are formed with a transverse recess.
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23. An implant according to claim 7 also comprising a base member which has formed on an outer facing peripheral surface thereof a bearing race defining an outer facing recess.
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24. An implant according to claim 6 wherein said disc replacement coil comprises a sprocket engagement belt having inwardly facing teeth arranged for operative engagement with an outer circular array of outwardly facing teeth of a sprocket.
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25. An implant according to claim 24 wherein said belt is assembled over said sprocket and is retained thereon by means of an inner facing peripheral protrusion which engages a transverse recess formed in said outwardly facing teeth.
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26. An implant according to claim 24 comprising an upstanding coil winding portion extending from said engagement belt.
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27. An implant according to claim 26 wherein said upstanding coil winding portion is formed with an extra thick portion which, when wound about said resilient element, seats under said engagement belt.
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28. An implant according to claim 26 wherein said upstanding coil winding portion is formed with at least one of a fiber reinforcing layer and a compression wire.
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29. An implant according to claim 26 wherein said upstanding coil winding portion is formed with a varying thickness, whereby the thickness of the upstanding coil when wound at various locations thereat corresponds to the desired configuration of the resulting replacement disc.
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30. An implant according to claim 26 wherein said upstanding coil winding portion is formed with varying mechanical properties, whereby the characteristics of the upstanding coil when wound at various locations thereat correspond to the desired characteristics of the resulting replacement disc.
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31. An implant according to claim 26 wherein said upstanding coil winding portion is wound about said resilient element by rotation of said sprocket, causing the upstanding coil winding portion to be tightly wound about said engagement belt and thus about the resilient element.
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32. An implant according to claim 26 wherein said upstanding coil winding portion is retained in a desired wound arrangement by means of engagement between one or more suitably disposed protrusions and corresponding sockets disposed adjacent an outer end of said coil winding portion.
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33. An implant according to claim 26 wherein said upstanding coil winding portion is formed with a series of apertures or outwardly facing sockets which may be engaged by an auxiliary coiling tool to assist in winding the coil winding portion about said resilient element.
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34. An implant according to claim 26 wherein said upstanding disc replacement coil includes a bearing race defining protrusion or recess retaining bearing balls therein, said protrusion or recess being located on a portion of the coil winding portion adjacent an engagement belt and positioned so that upon winding thereof about said engagement belt, bearing balls engage said bearing race.
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35. An implant according to claim 26 wherein said upstanding disc replacement coil includes a bearing race defining protrusion or recess engaging bearing rollers, said protrusion or recess being located on a portion of the coil winding portion adjacent an engagement belt and positioned so that upon winding thereof about said engagement belt, bearing rollers engage said bearing race.
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36. An implant according to claim 26 wherein said upstanding disc replacement coil includes a non flat cross-section along at least a portion of its length, wherein said coil winding portion terminates in a tail portion which is readily separable therefrom by a perforation.
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37. An implant according to claim 36 wherein said non flat cross-section defines at least one elongate recess on a first surface of a portion thereof and at least one pair of matching elongate recesses on a second surface of said portion.
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38. An implant according to claim 26 wherein said relative locations of said first and second surfaces are selected such that when the coil winding portion is tightly wound about the resilient element, said recesses on said first and second surfaces face each other and together define an enclosed space suitable for insertion thereinto of a flowable elastomer.
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39. An implant according to claim 36 wherein said non-flat cross-section is located along at least one of the top and bottom edges of said upstanding disc replacement coil.
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40. An implant according to claim 39 wherein said at least one of the top and bottom edges are configured to at least partially lockingly engage with one or more of peripheral recesses formed by suitable machining of end plates of vertebrae.
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41. An implant according to claim 40 wherein said peripheral recesses are formed with an undercut configuration and the cross-sections of at least one of the top and bottom edges are correspondingly configured
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42. An implant according to claim 6 wherein said disc replacement coil comprises multiple turns of a generally flat coil element.
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43. An implant according to claim 42, wherein said end plates lie generally in parallel planes and wherein said generally flat coil element lies generally in planes parallel to said parallel planes of said end plates.
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44. An implant according to claim 43 wherein said generally flat coil element includes portions having convex rounded cross-sectional surfaces which are seated in peripheral channels of respective ones of said end plates.
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45. An implant according to claim 43 wherein said generally flat coil element includes portions having undercut concave cross-sectional surfaces which face peripheral channels of respective ones of said end plates and a flowable polymer is inserted to fill interstices between adjacent coils at said concave cross-sectional surfaces and at said peripheral channels.
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46. An implant according to claim 43 wherein said generally flat coil element includes portions having undercut convex cross-sectional surfaces which lockingly seat in peripheral channels of respective ones of said end plates.
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47. An implant according to claim 43 wherein said generally flat coil element includes at least one rib and at least one lip, which engage hook-like portions of respective ones of said coils.
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48. An implant according to claim 43 wherein said generally flat coil element includes at least one flat disc replacement coil having formed thereon protrusions seating in respective recesses formed thereon.
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49. An implant according to claim 43 wherein said generally flat coil element includes at least one flat disc replacement coil which is held together by engagement elements.
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50. An implant according to claim 49 wherein said engagement elements lie in peripheral recesses formed in said end plates and are retained therein by means of a lowable polymer.
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51. An implant according to claim 43 wherein said generally flat coil element includes a double coil installed in situ between facing vertebrae.
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52. An implant according to claim 42 wherein said end plates lie generally in parallel planes and wherein said generally flat coil element lies generally perpendicular to said parallel planes of said end plates.
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53. An implant for use in spinal surgery according to claim 7 wherein said resilient element comprises an inflation valve operatively associated with said inflatable cavity, which permits inflation of said cavity to cause said resilient element to be in an inflated state and subsequent sealing of said cavity to retain said resilient element in said inflated state.
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54. An implant for use in spinal surgery according to claim 53 wherein said resilient element comprises an inflation conduit communicating with said inflation valve and extending outwardly thereof at least to a periphery of said end plates.
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81. An implant for use in spinal surgery according to claim 6 wherein said disc replacement coil comprises a main coil portion including a plurality of coils having at least three differing cross-sections and a tail portion which is removably connected to said main coil portion.
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82. An implant for use in spinal surgery according to claim 6 wherein said disc replacement coil comprises a head portion having a generally conical configuration and a lead coil portion, said head portion having a maximum cross-sectional dimension which is slightly greater than the maximum cross-sectional dimension of the lead coil portion.
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83. An implant for use in spinal surgery according to claim 6
wherein said disc replacement coil comprises a main coil portion including a plurality of coils at least one of which having a first generally omega-shaped cross-section. -
84. An implant for use in spinal surgery according to claim 83 wherein said first generally omega-shaped cross-section comprises a central region including a convex rounded cross-sectional surface which corresponds to a cross-sectional configuration of a channel formed in an end plate and a concave rounded cross-sectional surface.
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85. An implant for use in spinal surgery according to claim 84 wherein said plurality of coils includes at least one coil having a generally rectangular cross-section and a central rounded protrusion at the center thereof, defining a plurality of convex rounded cross-sectional surfaces at least one of which being configured to seat in said concave rounded surface.
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86. An implant for use in spinal surgery according to claim 85 wherein said plurality of coils includes at least one coil having a second generally omega-shaped cross-section.
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87. An implant for use in spinal surgery according to claim 86 wherein said second generally omega-shaped cross-section is a mirror-image of said first generally omega-shaped cross-section.
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88. An implant for use in spinal surgery according to claim 86 wherein said plurality of coils includes at least one coil having a third generally omega-shaped cross-section, identical to said second generally omega-shaped cross-section.
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89. An implant for use in spinal surgery according to claim 81 wherein said plurality of coils includes at least one coil which includes at an inner facing edge thereof a hook-like portion which is configured to lockingly engage a lip and a rib of an inflatable implant.
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90. An implant for use in spinal surgery according to claim 81 wherein said plurality of coils includes at least one coil which is formed with a transverse recess which permits access to an inflation valve.
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91. An implant for use in spinal surgery according to claim 81 wherein said plurality of coils includes at least one coil having inner facing edges formed to define channels which are configured to lockingly engage corresponding surfaces of a protrusion of an inflatable implant.
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92. An implant for use in spinal surgery according to claim 81 wherein said disc replacement coil comprises a connector coupled to a main coil portion via a perforated junction.
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93. An implant for use in spinal surgery according to claim 92 wherein said connector is configured and adapted to be readily mechanically coupled to an engagement socket of a coiled lead of an inflatable implant.
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94. An implant for use in spinal surgery according to claim 81 wherein said disc replacement coil is formed with undercut recesses on each of respective top and bottom surfaces thereof.
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95. An implant for use in spinal surgery according to claim 94 wherein said recesses extend substantially along the entire length of said coil.
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96. An implant for use in spinal surgery according to claim 81 wherein said disc replacement coil is formed with a generally rectangular cross-section having a first hook-like portion at an inner, bottom facing corner thereof and having a second hook-like portion at an outer, top facing corner thereof.
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97. An implant for use in spinal surgery according to claim 81 wherein said disc replacement coil is formed with a generally rectangular cross-section having a central slanted recess at a top facing surface thereof.
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98. An implant for use in spinal surgery according to claim 81 wherein said disc replacement coil is formed with a generally rectangular cross-section having two differing widths along its length defining a corrugated configuration.
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99. An implant for use in spinal surgery according to claim 81 wherein said disc replacement coil is formed with teeth and corresponding recesses which do not extend over the entire width of the coil, and thus serve to mutually align the individual coils in three dimensions.
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100. An implant for use in spinal surgery according to claim 81 wherein said disc replacement coil is formed with opposing engagement elements of two different types which are designed for secure engagement therebetween.
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119. An implant for use in spinal surgery according to claim 6 wherein said disc replacement coil comprises a head, a lead coil portion, a main coil portion and a tail portion.
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125. An implant for use in spinal surgery according to claim 6, wherein at least a portion of said disc replacement coil has a generally rectangular cross-section having toothed opposite facing surfaces
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127. An implant for use in spinal surgery according to claim 6 wherein at least a portion of said disc replacement coil is formed with opposite facing hook-type mutually engaging surfaces.
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7. An implant for use in spinal surgery according to claim 6, also comprising a resilient element having an inflatable cavity, said resilient element being formed of a biologically compatible material and being arranged for placement between end plates of adjacent vertebra interiorly of said disc replacement coil.
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101. An implant for use in spinal surgery comprising:
a disc replacement band assembly, said disc replacement band assembly being formed of a biologically compatible material and being arranged for placement between end plates of adjacent vertebra. - View Dependent Claims (102, 103, 104, 105, 106)
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102. An implant for use in spinal surgery according to claim 101 also comprising a resilient element having an inflatable cavity, said resilient element being formed of a biologically compatible material and being arranged for placement between end plates of adjacent vertebra interiorly of said disc replacement band assembly.
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103. An implant according to claim 101 wherein said disc replacement band assembly comprises at least one generally flat band element.
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104. An implant according to claim 103 wherein said end plates lie generally in parallel planes and wherein said at least one generally flat band element lies generally perpendicular to said parallel planes of said end plates.
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105. An implant for use in spinal surgery according to claim 102 wherein said resilient element comprises an inflation valve operatively associated with said inflatable cavity, which permits inflation of said cavity to cause said resilient element to be in an inflated state and subsequent sealing of said cavity to retain said resilient element in said inflated state.
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106. An implant for use in spinal surgery according to claim 105 wherein said resilient element comprises an inflation conduit communicating with said inflation valve and extending outwardly thereof at least to a periphery of said end plates.
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102. An implant for use in spinal surgery according to claim 101 also comprising a resilient element having an inflatable cavity, said resilient element being formed of a biologically compatible material and being arranged for placement between end plates of adjacent vertebra interiorly of said disc replacement band assembly.
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107. An implant for use in spinal surgery comprising:
a wound disc replacement element, said wound disc element being formed of a biologically compatible material and being arranged for placement between end plates of adjacent vertebra. - View Dependent Claims (108, 109, 110, 111, 112, 114, 115, 116, 117, 118, 120, 121, 122, 123, 124, 126, 130, 131, 132, 133, 134, 135, 136, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153, 154, 155, 156, 157, 158, 159, 160, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 172, 173, 174, 175, 176, 177, 178, 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197, 198, 199, 200, 201, 202, 203, 207, 208, 209, 283, 285)
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108. An implant for use in spinal surgery according to claim 107 wherein said wound disc replacement element comprises a wound filament.
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109. An implant for use in spinal surgery according to claim 107 wherein said wound disc replacement element comprises a wound strip.
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110. An implant for use in spinal surgery according to claim 107 also comprising a resilient element having an inflatable cavity, said resilient element being formed of a biologically compatible material and being arranged for placement between end plates of adjacent vertebra interiorly of a disc replacement coil.
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111. An implant according to claim 110 wherein said resilient element comprises an inflation valve operatively associated with said inflatable cavity, which permits inflation of said cavity to cause said resilient element to be in an inflated state and subsequent sealing of said cavity to retain said resilient element in said inflated state.
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112. An implant for use in spinal surgery according to claim 111 wherein said resilient element comprises an inflation conduit communicating with said inflation valve and extending outwardly thereof at least to a periphery of said end plates.
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114. An implant for use in spinal surgery according to claim 113 wherein said resilient element also comprises a multi-coil spiral outwardly extending rib located on said peripheral edge surface.
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115. An implant for use in spinal surgery according to claim 114, wherein said resilient element also comprises a lip formed onto said multi-coil spiral outwardly extending rib for providing enhanced locking engagement of a disc replacement implant with said resilient element.
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116. An implant for use in spinal surgery according to claim 114 wherein said resilient element also comprises a protrusion formed onto said multi-coil spiral outwardly extending rib for providing enhanced locking engagement of a disc replacement implant with said resilient element.
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117. An implant for use in spinal surgery according to claim 114 also comprising a lead coiled about said resilient element along said multi-coil spiral outwardly extending rib.
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118. An implant for use in spinal surgery according to claim 117 wherein said lead is formed with engagement elements at opposite ends thereof, one of such engagement elements being adapted to be attached to a forward end of a flat disc replacement coil, another one of such engagement elements being adapted to be hooked onto by a suitable pulling tool.
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120. An implant for use in spinal surgery according to claim 119 wherein said main coil portion comprises, at an inner facing edge thereof, a hook-like portion which is configured to lockingly engage said resilient element.
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121. An implant for use in spinal surgery according to claim 119 wherein said main coil portion is formed with at least one undercut recess on at least one surface thereof, said recess extending along the length of the main coil portion.
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122. An implant for use in spinal surgery according to claim 121 wherein said main coil portion is also formed with at least one undercut protrusion on at least one surface thereof, said protrusion extending along the length of the main coil portion and being configured for locking engagement with said at least one undercut recess.
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123. An implant for use in spinal surgery according to claim 119 wherein said main coil portion is formed with at least one first hooking portion on at least one surface thereof, said at least one first hooking portion extending along the length of the main coil portion.
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124. An implant for use in spinal surgery according to claim 123, wherein said main coil portion is also formed with at least one second hooking portion on at least one surface thereof, said at least one second hooking portion extending along the length of the main coil portion and being configured for locking engagement with said at least one first hooking portion.
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126. An implant for use in spinal surgery according to claim 125, wherein said toothed opposite facing surfaces do not extend over the entire width of the coil, and thus serve to mutually align overlapping portions of said coil in three dimensions.
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130. A method of performing spinal surgery on a patient according to claim 129 also comprising:
planning and visualizing a computer controlled surgical approach path, in order to maximize avoidance of vital organs, nerves and blood vessels.
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131. A method of performing spinal surgery on a patient according to claim 129
wherein said utilizing step employs patient data stored in a computer memory as well as imaging data derived from earlier patient imaging and reference medical data, said reference medical data including medical imaging information currently available on computer networks. -
132. A method of performing spinal surgery on a patient according to claim 129
wherein said imaging step comprises determining a desired patient orientation for preoperative imaging and performing computer simulated imaging based on the desired patient orientation. -
133. A method of performing spinal surgery on a patient according to claim 129
wherein said securely mounting step includes orienting said support table by downloading data indicating a desired patient orientation from a computer. -
134. A method of performing spinal surgery on a patient according to claim 129
wherein patient imaging is supplemented in a region of interest with medical reference data and composite images are provided, characterized in that patient imaging data is clearly distinguished from overlaid reference data. -
135. A method of performing spinal surgery on a patient according to claim 130 comprising:
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determining a navigation path of a first cannula subassembly in three spatial dimensions and over time; and
determining an anchoring location for said first cannula subassembly.
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136. A method of performing spinal surgery on a patient according to claim 135, wherein there is provided a second cannula subassembly, and further comprising:
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determining the pathway and timing of the insertion of a third cannula subassembly over first and second cannula subassemblies; and
determining an intended anchoring location for said third cannula subassembly.
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137. A method of performing spinal surgery on a patient according to claim 129
wherein the utilizing step comprises: -
determining the timing of removal from the body of the patient of a first cannula subassembly, a second cannula subassembly and an inner portion of a third cannula subassembly; and
determining the timing and technique to be used for suctioning of a disc.
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138. A method of performing spinal surgery on a patient according to claim 129 wherein the utilizing step comprises:
planning restoration of end plates of vertebrae utilizing surgical vehicles and milling tools.
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139. A method of performing spinal surgery on a patient according to claim 138
wherein said restoration includes an initial milling stage defining a recess for an inflatable pillow. -
140. A method of performing spinal surgery on a patient according to claim 139
wherein the inflatable pillow is a generally “ - bean shaped”
inflatable pillow.
- bean shaped”
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141. A method of performing spinal surgery on a patient according to claim 139
wherein said restoration also comprises defining at least one channel in said end plate. -
142. A method of performing spinal surgery on a patient according to claim 138 also comprising planning insertion of an inflatable implant in a recess formed in at least one end plate.
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143. A method of performing spinal surgery on a patient according to claim 138
wherein said restoration comprises insertion of a top surface plate following suitable machining of the top surface of an end plate. -
144. A method of performing spinal surgery on a patient according to claim 138
wherein said restoration comprises providing a recess encompassing a buckled portion of an end plate for receiving a bone graft and inserting a bone graft in said recess. -
145. A method of performing spinal surgery on a patient according to claim 138
wherein said restoration comprises providing treatment for scoliosis by providing a seat and a channel for securely receiving a bone graft and inserting a bone graft at said seat and said channel with precise dimensions corresponding to those of said seat and said channel such that a portion of the bone graft protrudes from a top surface of the end plate. -
146. A method of performing spinal surgery on a patient according to claim 129 also comprising planning insertion of an inflatable implant between end plates of adjacent vertebra by employing tools including, an inflation tool in association with a surgical vehicle.
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147. A method of performing spinal surgery on a patient according to claim 129 also comprising planning insertion of a disc replacement implant surrounding the inflatable implant.
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148. A method of performing spinal surgery on a patient according to claim 147
wherein said disc replacement implant comprises a flat disc replacement coil. -
149. A method of performing spinal surgery on a patient according to claim 147
wherein said disc replacement implant comprises an upstanding disc replacement coil. -
150. A method of performing spinal surgery on a patient according to claim 129 wherein said utilizing step comprises carrying out a simulated operation on a computer in an off-tine manner.
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151. A method of performing spinal surgery on a patient according to claim 150, wherein the step of carrying out a simulated operation employs stored patient image data and is linked to the intended configuration of the implant and its operating environment.
-
152. A method of performing spinal surgery on a patient according to claim 150
wherein during the step of carrying out a simulated operation, the surgeon modifies at least one aspect of a planned operation. -
153. A method of performing spinal surgery on a patient according to claim 150 also including applying computerized analysis to the simulated operation.
-
154. A method of performing spinal surgery on a patient according to claim 150 also including providing computer generated comments and warnings to an operator based on said computerized analysis.
-
155. A method of performing spinal surgery on a patient according to claim 129 also comprising planning disc suctioning.
-
156. A method of performing spinal surgery on a patient according to claim 129 wherein said step of utilizing the image file for planning and carrying out computer controlled spinal surgery on the patient, comprises the steps of:
-
extracting a cannula entry position from a final real time starting operation plan;
positioning the patient as required; and
inserting the first cannula subassembly into the patient in accordance with said final real time starting operation plan as modified interactively in real time by the surgeon.
-
-
157. A method of performing spinal surgery on a patient according to claim 156
wherein said step of inserting the first cannula subassembly into the patient comprises the steps of: -
initiating penetration of the first cannula subassembly into the patient; and
using the final real time starting operation plan as modified interactively in real time by the surgeon, causing a desired sequence of coordinated movements of the first cannula subassembly, said coordinated movements including at least one of linear forward motion of the first cannula subassembly, rotation of the first cannula subassembly and curvature control of the first cannula subassembly.
-
-
158. A method of performing spinal surgery on a patient according to claim 157
wherein said step of causing a desired sequence of coordinated movements of the first cannula subassembly is effected by provision of synchronized instructions to a controller for operation of at least one motor and at least one piston of a steering subassembly. -
159. A method of performing spinal surgery on a patient according to claim 157
wherein said step of causing a desired sequence of coordinated movements of the first cannula subassembly is effected by employing real-time imaging. -
160. A method of performing spinal surgery on a patient according to claim 158
wherein the provision of synchronized instructions is terminated upon engagement of said first cannula subassembly with a target location. -
161. A method of performing spinal surgery on a patient according to claim 160
wherein the target is a disc. -
162. A method of performing spinal surgery on a patient according to claim 158
wherein the engagement of said first cannula subassembly with a disc is evidenced at least partially by real-time imaging. -
163. A method of performing spinal surgery on a patient according to claim 156 also comprising the step of anchoring of the first cannula subassembly into the spine at an anchoring location.
-
164. A method of performing spinal surgery on a patient according to claim 156 wherein said step of anchoring said first cannula subassembly into the disc at an anchoring location comprises rotational threaded engagement of an anchoring screw of said first cannula subassembly into said spine.
-
165. A method of performing spinal surgery on a patient according to claim 163 wherein the anchoring location is at a disc.
-
166. A method of performing spinal surgery on a patient according to claim 156 also comprising the step of sliding said second cannula subassembly over the first cannula subassembly.
-
167. A method of performing spinal surgery on a patient according to claim 166,
wherein said sliding step takes place after said steering subassembly is removed from the first cannula subassembly. -
168. A method of performing spinal surgery on a patient according to claim 166,
wherein said sliding step comprises the following steps: -
inserting the second cannula subassembly along the outside of the first cannula subassembly, under initiation by the surgeon;
providing a desired sequence of movements of the second cannula subassembly, derived from the final real time starting operation plan as modified interactively in real time by the surgeon;
providing linear forward motion of the second cannula subassembly, using a motor in response to inputs supplied thereto by a controller;
when the second cannula subassembly reaches said disc, turning off said motor by said controller; and
thereafter, locking said second cannula subassembly into engagement with the first cannula subassembly.
-
-
169. A method of performing spinal surgery on a patient according to claim 141 also comprising the step of sliding said third cannula subassembly over said second cannula subassembly.
-
170. A method of performing spinal surgery on a patient according to claim 169
wherein said step of sliding said third cannula subassembly takes place in accordance with a final real time operation plan as modified interactively in real time by the surgeon. -
171. A method of performing spinal surgery on a patient according to claim 169
wherein said step of sliding said third cannula subassembly comprises the following steps: -
inserting the third cannula subassembly along the outside of the second cannula subassembly under initiation by the surgeon;
providing a desired sequence of movements of the third cannula subassembly, which sequence is derived from the final real time starting operation plan as modified interactively in real time by the surgeon;
providing linear forward motion of the third cannula subassembly, using a motor in response to inputs supplied thereto by a controller; and
turning off said motor from said controller when an intended target location of the third cannula subassembly is reached.
-
-
172. A method of performing spinal surgery on a patient according to claim 171
wherein said step of sliding said third cannula subassembly employs at least one blade disposed adjacent a forward edge of the third cannula subassembly. -
173. A method of performing spinal surgery on a patient according to claim 145 wherein said step of sliding said third cannula subassembly also includes location corrections to the locations of said first and second cannula subassemblies.
-
174. A method of performing spinal surgery on a patient according to claim 173
wherein said location corrections are achieved by modifying a curvature of the third cannula subassembly through use of a steering subassembly. -
175. A method of performing spinal surgery on a patient according to claim 174
wherein said step of modifying the curvature of the third cannula subassembly through use of a steering subassembly is achieved using real time high accuracy imaging information. -
176. A method of performing spinal surgery on a patient according to claim 148 also comprising the step of coupling the third cannula subassembly to the second cannula subassembly.
-
177. A method of performing spinal surgery on a patient according to claim 149 wherein following locking of an inner portion of the third cannula subassembly to said second cannula subassembly, an outer portion of the third cannula subassembly is decoupled from an inner portion thereof.
-
178. A method of performing spinal surgery on a patient according to claim 177
wherein following decoupling of said outer portion and said inner portion of said third cannula subassembly, a controller operates a motor to move said outer portion forward relative to said inner portion until the forward edge of the outer portion engages vertebrae. -
179. A method of performing spinal surgery on a patient according to claim 178, wherein following engagement of said outer portion with said vertebrae, anchoring screws threadably engage a vertebra, thus anchoring said outer portion of the third cannula subassembly to said vertebra.
-
180. A method of performing spinal surgery on a patient according to claim 129 also comprising the steps of withdrawal of said first and second cannula subassemblies and the inner portion of the third cannula subassembly through said outer portion of the third cannula subassembly.
-
181. A method of performing spinal surgery on a patient according to claim 180
also comprising the step of disc suctioning. -
182. A method of performing spinal surgery on a patient according to claim 180 also comprising the step of vertebrae machining.
-
183. A method of performing spinal surgery on a patient according to claim 180 also comprising the step of disc implantation.
-
184. A method of performing spinal surgery on a patient according to claim 180 also comprising the step of vertebra end plate reconstruction.
-
185. A method of performing spinal surgery on a patient according to claim 182
wherein the step of vertebrae machining includes an initial milling stage defining a recess for an implant. -
186. A method of performing spinal surgery on a patient according to claim 185,
wherein said initial milling stage defines a recess for an inflatable pillow as well as a network of channels including a plurality of generally radially directed channels and a peripheral channel. -
187. A method of performing spinal surgery on a patient according to claim 185,
wherein said inflatable pillow is generally “ - bean shaped”
.
- bean shaped”
-
188. A method of performing spinal surgery on a patient according to claim 186
wherein in said initial milling stage, a generally central region of a top surface of an end plate is milled to provide a generally smooth milled surface having a recess formed generally at the center thereof. -
189. A method of performing spinal surgery on a patient according to claim 184
wherein said step of vertebra end plate reconstruction includes the steps of employing a surgical vehicle, a hand and a pair of forceps tools to insert, position and spread out a reinforcing fabric over a machined surface of an end plate. -
190. A method of performing spinal surgery on a patient according to claim 189
wherein said reinforcing fabric is impregnated with an adhesive which is activated in situ. -
191. A method of performing spinal surgery on a patient according to claim 189
wherein said reinforcing fabric is adhered using a fluid adhesive. -
192. A method of performing spinal surgery on a patient according to claim 184 wherein said step of vertebra end plate reconstruction includes the steps of machining of a top surface of an end plate and subsequent insertion and placement thereover of at least one top surface plate.
-
193. A method of performing spinal surgery on a patient according to claim 192
wherein said at least one top surface plate is impregnated with an adhesive which is activated in situ. -
194. A method of performing spinal surgery on a patient according to claim 192,
wherein said at least one top face plate is adhered using a fluid adhesive. -
195. A method of performing spinal surgery on a patient according to claim 192
wherein said at least one top face plate is adhered to the vertebra by fasteners -
196. A method of performing spinal surgery on a patient according to claim 184 wherein said step of vertebra end plate reconstruction includes the steps of employing a surgical vehicle, a hand and a pair of forceps tools to insert, position and adhere a bone graft in engagement with a machined surface of an end plate.
-
197. A method of performing spinal surgery on a patient according to claim 184 wherein said step of machining of a top surface of an end plate comprises using a surgical vehicle, a hand and a milling head to provide a generally smooth milled surface having a recess formed generally at the center thereof.
-
198. A method of performing spinal surgery on a patient according to claim 184 wherein said step of machining of a top surface of an end plate comprises using a surgical vehicle, a hand and a milling head to provide a generally smooth milled surface having a channel and a recess formed generally at the center thereof.
-
199. A method of performing spinal surgery on a patient according to claim 184 wherein said step of machining of a top surface of an end plate comprises using a surgical vehicle, a hand and a milling head to provide a generally smooth milled surface having a channel and a generally oval recess formed generally at the center thereof as an extension of said channel.
-
200. A method of performing spinal surgery on a patient according to claim 197 wherein said step of machining of a top surface of an end plate also comprises using a surgical vehicle, a hand and a milling head to provide at least one peripheral channel surrounding said recess.
-
201. A method of performing spinal surgery on a patient according to claim 200
wherein said step of machining of a top surface of an end plate also comprises using a surgical vehicle, a hand and a milling head to provide at least one newly peripheral channel, having ends which extend to an edge of the end plate. -
202. A method of performing spinal surgery on a patient according to claim 200
wherein said at least one peripheral channel surrounding said recess has a generally semicircular cross-sectional configuration. -
203. A method of performing spinal surgery on a patient according to claim 200
wherein said at least one peripheral channel surrounding said recess has a keystone undercut cross-sectional configuration. -
207. A method for performing spinal surgery according to claim 129
also including insertion of a fusion implant including at least one bone graft. -
208. A method for performing spinal surgery according to claim 207 wherein said fusion implant comprises at least one bone graft enclosed in an enclosure made of a biologically compatible material and being arranged for placement between end plates of adjacent vertebra.
-
209. A method for performing spinal surgery according to claim 208 wherein said fusion implant comprises a plurality of bone graft segments, each enclosed in an enclosure made of a biologically compatible material, said plurality of segments also being together enclosed in an enclosure made of a biologically compatible material.
-
283. A method according to claim 148 wherein said flat disc replacement coil is inserted by the following steps:
-
inflation of an inflatable implant located between adjacent vertebra end plates; and
slidingly inserting tools between said adjacent vertebra end plates, said tools including flexible battens having edge protrusions which lie in channels formed in said end plates.
-
-
285. A method according to claim 148 wherein:
-
an inflatable implant is located between adjacent vertebrae and is inflated;
an upstanding disc replacement coil transporter and dispenser is located adjacent vertebrae;
at least one tool including a flexible batten is employed to engage an upstanding coil winding portion of a coil supplied by said disc replacement coil transporter and dispenser and to assist in coiling it about said inflatable implant; and
a dispenser tool is employed in order to provide a flowable bonding material to the coil winding portion as it is being coiled about said inflatable implant.
-
-
108. An implant for use in spinal surgery according to claim 107 wherein said wound disc replacement element comprises a wound filament.
-
129. A method of performing spinal surgery on a patient comprising:
-
securely mounting a patient onto a patient support table;
imaging a spinal region of the patient;
building up a three dimensional image file of the spinal region of the patient, storing the image file; and
utilizing the image file for planning and carrying out computer controlled spinal surgery on the patient.
-
-
204. A method of treating scoliosis comprising vertebra end plate reconstruction and including the steps of employing a surgical vehicle, a hand and a pair of forceps tools to insert a bone graft into engagement with a machined surface of a vertebra end plate.
- View Dependent Claims (205, 206)
-
205. A method of treating scoliosis according to claim 204 where in said bone graft is in the form of a wedge which is attached at a seat and secured in a channel machined into said vertebra end plate.
-
206. A method of treating scoliosis according to claim 204 wherein, following attachment of the bone graft, a top surface of the bone graft is machined to be flush with the remainder of top surface of said end plate.
-
205. A method of treating scoliosis according to claim 204 where in said bone graft is in the form of a wedge which is attached at a seat and secured in a channel machined into said vertebra end plate.
-
210. A method for performing spinal surgery comprising the steps of insertion and inflation of an inflatable implant between facing end plates of adjacent vertebrae.
- View Dependent Claims (211, 212, 213, 214, 215, 216, 217, 218, 219, 220, 270)
-
211. A method according to claim 210 wherein said insertion and inflation employs a plurality of surgical vehicles, a plurality of hands and a plurality of tools.
-
212. A method according to claim 210 also comprising application of traction to the vertebrae in a controlled manner.
-
213. A method according to claim 210 also comprising at least one of end plate reconstruction, reinforcement and machining prior to insertion of said inflatable implant.
-
214. A method according to claim 210 wherein insertion of said inflatable implant between said end plates employs a pair of pick and place tools, each mounted on a surgical vehicle via a hand, as well as an inflation tool, mounted on a surgical vehicle via a hand.
-
215. A method according to claim 210 wherein said inflatable implant, upon insertion thereof between said end plates, is partially deflated and is subsequently inflated, thereby to cause expansion of said implant.
-
216. A method according to claim 210 comprising employing a gauging tool for measuring at least one of the extent of inflation of said inflatable implant and the resulting separation between adjacent vertebrae.
-
217. A method according to claim 210 comprising employing marks placed on at least one of said inflatable implant and adjacent vertebrae to enable the orientation thereof to be sensed.
-
218. A method according to claim 216 comprising supplying information derived from at least one of a gauging tool and marks planed on at least one of said inflatable implant and adjacent vertebrae to a computer for at least one of confirmation and interactive modification of a final real time starting operation plan.
-
219. A method according to claim 210 wherein said inflatable implant comprises an inflatable portion and a protruding inflation conduit, which enables selectable inflation and deflation of said inflatable implant without interference from other implants subsequently inserted surrounding said inflatable implant.
-
220. A method according to claim 219 wherein said inflatable portion is generally “
- bean shaped”
- bean shaped”
-
270. A method according to claim 210 wherein following completion of end plate reconstruction and reinforcement and suitable end plate machining an inflatable implant assembly including an engagement belt of an upstanding disc replacement coil, engaging teeth of a sprocket and a driving belt, said driving belt being drivingly coupled to an upstanding disc replacement coil transporter and dispenser and engaging teeth of a sprocket therein, is inserted between end plates of respective adjacent vertebra.
-
211. A method according to claim 210 wherein said insertion and inflation employs a plurality of surgical vehicles, a plurality of hands and a plurality of tools.
-
221. A method for performing spinal surgery comprising the steps of insertion, between facing end plates of adjacent vertebrae, of a flat disc replacement coil.
- View Dependent Claims (222, 223, 224, 225, 226, 227, 228, 229, 230, 231, 232, 233, 234, 235, 236, 237, 238, 239, 240, 242, 243, 244, 245, 246, 247, 248, 249, 250, 251, 252, 254, 255, 256, 257, 258, 259, 260, 261, 262, 263, 264, 265, 266, 267, 268, 269, 271, 272, 273, 274, 275, 276, 277, 278, 279, 280, 281, 282, 284, 286, 287, 288, 289, 290, 291, 292, 294, 295, 297, 298, 299, 300, 301, 302, 303, 304, 305, 306, 307)
-
222. A method according to claim 221, wherein said insertion employs a flat disc replacement coil transporter and dispenser.
-
223. A method according to claim 222 wherein said insertion also employs at least one surgical vehicle, at least one hands and at least one tool.
-
224. A method according to claim 223 wherein a surgical vehicle is located alongside said flat disc replacement coil transporter and dispenser and has a hand mounted thereon.
-
225. A method according to claim 223 wherein a coil forceps tool is mounted on said hand which is in turn mounted on said surgical vehicle.
-
226. A method according to claim 221 wherein forward and intermediate coil driving assemblies of said flat disc replacement coil transporter and dispenser are operated to push a lead coil portion of said flat disc replacement coil forwardly relative to said transporter and dispenser.
-
227. A method according to claim 226 wherein, due to its pre-coiled configuration, said lead coil portion tends to coil about said inflatable implant.
-
228. A method according to claim 226 wherein a forceps tool engages a coil head of said lead coil portion using finger pairs and a guiding finger for pulling said coil head and assisting in coiling of said lead coil portion about said inflatable implant.
-
229. A method according to claim 228 wherein at the stage of coiling of said lead coil portion about said inflatable implant a main coil portion of said disc replacement coil mainly remains coiled in a coil storage bay in said flat disc replacement coil transporter and dispenser, the forward part of the main portion extending forwardly of said storage bay, following the lead coil portion, which is engaged by at least one of intermediate and forward coil driving assemblies of said flat disc replacement coil transporter and dispenser.
-
230. A method according to claim 221 wherein during continued coiling of the lead coil portion about said inflatable implant a tool is gradually repositioned so as to guide the lead coil portion for producing a desired coil configuration.
-
231. A method according to claim 230 wherein during continued coiling of the lead coil portion about said inflatable implant, a coil forceps tool engages said lead coil portion and said coil head using finger pairs and a guiding finger for pulling said coil head and said lead coil portion and assisting in continued coiling of the lead coil portion about the inflatable implant.
-
232. A method according to claim 231 wherein said main coil portion extends forwardly of said storage bay through a coil feeder, following said lead coil portion, and through an intermediate coil driving assembly.
-
233. A method according to claim 221 wherein during continued coiling of the lead coil portion about said inflatable implant, a tool is employed in order to provide a flowable bonding material to the main coil portion as it is being coiled about said inflatable implant.
-
234. A method according to claim 233 wherein a coil forceps tool engages and pulls a coil head rearwardly, thus assisting in coiling of a main coil portion about said inflatable implant.
-
235. A method according to claim 234 wherein said main coil portion extends through the entire extent of said coil transporter and dispenser via at least one coil feeder and at least one of intermediate and forward coil driving assemblies.
-
236. A method according to claim 221 wherein following coiling of the lead coil portion about said inflatable implant, the coil head and most of the lead coil portion are retracted into a third cannula subassembly.
-
237. A method according to claim 236 wherein a laser cutting tool is employed for cutting a tail portion from a coiled main coil portion of a disc replacement coil.
-
238. A method according to claim 237 wherein said laser cutting tool is also employed for cutting said lead coil portion from said coiled main coil portion.
-
239. A method according to claim 221 wherein following coiling of the main coil portion about said inflatable implant, the inflatable implant is slightly deflated.
-
240. A method according to claim 221 wherein said flat disc replacement coil is a leadless flat disc replacement coil.
-
242. A method according to claim 241 wherein said insertion step employs a flat disc replacement coil transporter and dispenser having a pair of hands mounted on quick connection mounting assemblies thereof.
-
243. A method according to claim 242 wherein initially, in said insertion step, while the flat disc replacement coil transporter and dispenser lies outside an outer portion of a third cannula subassembly, connectors of a leadless coil in said coil transporter and dispenser are manually connected to engagement sockets of said pre-coiled lead.
-
244. A method according to claim 243 wherein following said manual connection, the flat disc replacement coil transporter and dispenser is inserted into and proceeds through the third cannula subassembly to a location adjacent vertebrae.
-
245. A method according to claim 221 wherein said flat disc replacement coil transporter and dispenser is driven by at least one surgical vehicle docked thereto, whilst a winch takes up slack in said pre-coiled lead.
-
246. A method according to claim 244 wherein during positioning of the flat disc replacement coil transporter and dispenser adjacent vertebrae, a tool, mounted via a hand onto a surgical vehicle, may be employed to engage said pre-coiled lead for maintaining a desired orientation thereof.
-
247. A method according to claim 246 wherein said tool, is operative to engage and thus direct a main coil portion of said coil for proper desired coiling thereof about said inflatable implant.
-
248. A method according to claim 247 wherein during said insertion, a connector of said coil and an engagement socket of said coiled lead are drawn inwardly towards a winch, while a corresponding length of a main coil portion of said coil is played out.
-
249. A method according to claim 241 wherein at a second stage in the insertion of said flat disc replacement coil, continued coiling of the main coil portion takes place about said inflatable implant.
-
250. A method according to claim 241 wherein at a third stage in the insertion of said flat disc replacement coil, when a cable and a lead coil portion have been wound on a winch, a laser cutting tool is employed for cutting a tail portion from a coiled main coil portion.
-
251. A method according to claim 250 wherein said laser cutting tool is also employed for cutting a connector from said main coil portion.
-
252. A method according to claim 251 wherein following coiling of the main coil portion about said inflatable implant, the inflatable implant is slightly deflated.
-
254. A method according to claim 253 also including the step of inserting between said facing end plates an inflatable implant assembly.
-
255. A method according to claim 254 wherein the step of inserting said inflatable implant assembly includes inserting an inflatable implant assembly having a circular implant portion such that an engagement belt of a wound filament disc replacement coil assembly engages teeth of a sprocket, and a driving belt, being drivingly coupled to a disc replacement transporter and engaging teeth of a sprocket thereof, is inserted between said end plates.
-
256. A method according to claim 255 wherein said step of inserting employs an inflation tool which is premounted onto said implant assembly and is operatively coupled thereto via a valve.
-
257. A method according to claim 256 wherein said implant portion of inflatable implant assembly, upon initial insertion thereof between said end plates is somewhat deflated and is subsequently inflated by means of said inflation tool.
-
258. A method according to claim 257 wherein a gauging tool is employed for measuring the extent of inflation of at least one of the implant portion and the resulting separation between adjacent vertebrae.
-
259. A method according to claim 257 wherein a sensor is employed for measuring the extent of inflation of at least one of the implant portion and the resulting separation between adjacent vertebrae.
-
260. A method according to claim 258 wherein the measured extent of inflation of at least one of the implant portion and the resulting separation between adjacent vertebrae is supplied to a computer for at least one of confirmation purposes and interactive modification of a final real time starting operation plan.
-
261. A method according to claim 254 wherein said step of inserting said inflatable implant assembly between said facing end plates comprises a first stage wherein when the inflatable implant assembly is located between adjacent vertebrae, the inflatable implant assembly is suitably inflated and when a disc replacement transporter and dispenser is located between adjacent vertebrae, a lead portion already having been wound about said inflatable implant portion, a tool is employed to engage a filament for desired positioning of said filament as it is wound about said inflatable implant portion.
-
262. A method according to claim 261 also comprising employing a dispenser tool in order to provide flowable bonding material to the wound filament coiled about said inflatable implant portion.
-
263. A method according to claim 261 wherein said step of inserting said inflatable implant assembly between said facing end plates also comprises a second stage wherein winding of the filament takes place in a manner such that filament crossovers occur generally in a desired given region, which may be identified in planning and carrying out the operation by reference to a system of polar coordinates.
-
264. A method according to claim 260 wherein said step of inserting said inflatable implant assembly between said facing end plates also comprises a stage wherein winding of the filament takes place in a manner such that filament crossovers occur generally in multiple regions, which may be identified in planning and carrying out the operation.
-
265. A method according to claim 263 wherein by selecting a number and location of the crossovers about the inflatable implant, the configuration of the wound filament disc replacement is determined.
-
266. A method according to claim 260 wherein by selecting number, type and location of variations in cross-section of a filament winding portion, the configuration of the wound filament disc replacement is determined.
-
267. A method according to claim 260 comprising selecting a number of filament coils at various distances along the separation between adjacent vertebrae.
-
268. A method according to claim 260 wherein filament coils are located within corresponding undercut recesses machined into at least one end plate, thus providing a desired interconnection therewith.
-
269. A method according to claim 268 wherein said filament coils include biomaterials.
-
271. A method according to claim 270 wherein said insertion employs at least one tool mounted on a surgical vehicle via a hand.
-
272. A method according to claim 270 also employing a tool, mounted on said upstanding disc replacement coil transporter and dispenser via a hand and positioned between said engagement belt and said coil portion.
-
273. A method according to claim 272 wherein said upstanding disc replacement coil transporter and dispenser contains a coil in an orientation ready for winding as well as a driving belt in an orientation ready for driving the sprocket of an implant assembly.
-
274. A method according to claim 273 wherein an inflation tool is premounted onto said implant assembly and is operatively coupled thereto via a valve.
-
275. A method according to claim 274 wherein when the inflatable implant assembly is located between adjacent vertebrae and is suitably inflated and when the upstanding disc replacement coil transporter and dispenser is located adjacent said vertebrae, a tool, mounted via a hand onto said upstanding disc replacement coil transporter and dispenser, is employed to engage said upstanding coil winding portion of said coil, said tool being positioned adjacent said vertebrae.
-
276. A method according to claim 275 wherein another tool, mounted via a second hand onto a second surgical vehicle, is operative to assist in winding the coil winding portion.
-
277. A method according to claim 276 wherein a dispenser tool is employed in order to provide a flowable bonding material to the coil winding portion as it is being coiled about said inflatable implant portion.
-
278. A method according to claim 274 wherein when the inflatable implant assembly is located between adjacent vertebrae a motor drives said driving belt in driving engagement with said sprocket, causing said engagement belt to wind the coil winding portion about said engagement belt and about said inflatable implant portion and during this winding procedure, forward and rearward coil driving assemblies of said coil transporter and dispenser push the coil winding portion, thus participating in the winding thereof.
-
279. A method according to claim 274 wherein coordination between the operation of said motor and operation of said coil driving assemblies governs the tightness of the wound coil.
-
280. A method according to claim 274 wherein a laser cutting tool is employed for cutting a tail portion from a coiled main coil portion.
-
281. A method according to claim 280 wherein said laser cutting tool is also employed for cutting a connector from said main coil portion.
-
282. A method according to claim 274 wherein following coiling of the main coil portion about said inflatable implant, the inflatable implant is slightly deflated.
-
284. A method according to claim 283 wherein said inflatable implant is thereafter slightly deflated, to an extent that the outer dimensions of the implant are decreased, thereby tightly engaging battens between said end plates, increasing the space between the implant and the battens, while the implant is still retained in an immobilized state between said end plates.
-
286. A method according to claim 285 wherein said upstanding disc replacement coil is pushed by forward and rearward coil driving assemblies of the disc replacement coil transporter and dispenser into winding engagement around said implant.
-
287. A method according to claim 286 wherein said upstanding disc replacement coil is pushed by forward and rearward coil driving assemblies of the disc replacement coil transporter and dispenser into winding engagement around said implant by causing a tip of the coil to slide along an inner surface of an enclosure defined by at least one batten.
-
288. A method according to claim 287 also comprising employing an additional tool to at least one of push and pull the coil winding portion, by engagement with at least one socket formed thereon, thus at least partially governing the tightness of the wound coil.
-
289. A method according to claim 287 wherein said coil winding portion adjacent said tip is engaged by a concave surface of a tool to contain said coil winding portion within said enclosure and thus to cause it to form a second coil therewithin.
-
290. A method according to claim 287 wherein following coiling of said coil winding portion about said inflatable implant and further inflation thereof, said coil winding portion is locked in tightly wound engagement with said inflatable implant and said battens are slidably disengaged from said recesses.
-
291. A method according to claim 290 wherein tightening of said coil winding portion about said inflatable implant produces engagement of ribs on said implant into corresponding recesses on said coil winding portion.
-
292. A method according to claim 290 also comprising deflation of said inflatable implant following disengagement of said battens.
-
294. A method for insertion of an implant according to claim 293 wherein said step of inserting comprises introducing at least one outer band between said facing end plates while said at least one outer band is initially retained in a narrowed configuration.
-
295. A method for insertion of an implant according to claim 294, wherein said step of inserting comprises introducing at least one inner band between said facing end plates following insertion of said at least one outer band and while said at least one inner band is initially retained in a narrowed configuration.
-
297. A method according to claim 296 also comprising, prior to insertion of an inflatable implant in a folded orientation and at least one disc replacement band coupled thereto between said end plates, the steps of:
-
inserting an inflatable implant between said end plates, said inflatable implant being partially deflated upon insertion thereof between said end plates;
employing an inflation tool, which is pre-attached to an outward end of a conduit in communication with a valve forming part of said inflatable implant to inflate said inflatable implant, thus causing expansion of the inflatable implant;
following inflation of the inflatable implant to a required extent, slidingly inserting batten bearing tools between adjacent end plates by means of forceps tools, such that edge protrusions of battens thereof lie in channels of respective end plates thereafter, slightly deflating the inflatable implant, to an extent that the outer dimensions of the implant are decreased thereby tightly engaging said battens between respective end plates, thereby increasing the space between the inflatable implant and said battens, while said implant is still retained in an immobilized state between said end plates;
deflating said inflatable implant; and
removing said inflatable implant from between respective end plates.
-
-
298. A method according to claim 293 wherein said at least one disc replacement band comprises a single band.
-
299. A method according to claim 293 wherein said at least one disc replacement band comprises two bands which are tightly held together by inflation of said inflatable implant.
-
300. A method according to claim 293 wherein said at least one disc replacement band comprises two bands having mutually interlocking portions which are caused to lockingly engage by inflation of said inflatable implant.
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301. A method according to claim 293 wherein said at least one disc replacement band comprises two bands having mutually interlocking portions, said inflatable implant also includes an interlocking portion and wherein said two bands and said inflatable implant are caused to lockingly engage by inflation of said inflatable implant.
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302. A method according to claim 293, wherein a flowable polymer is introduced into a volume defined at least between portions of said at least one disc replacement band and adjacent surfaces of said end plates and is operative, once set, to lock said portions of said at least one disc replacement band together in flexible engagement.
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303. A method according to claim 293 wherein locking engagement of portions of said at least one disc replacement band is provided by press fit engagement between inwardly facing edges of said at least one disc replacement band and corner edge recesses thereof.
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304. A method according to claim 293 wherein a flowable polymer is introduced into a volume defined at least by channels having an undercut cross-sectional configuration and being formed in said end plates, such that once set, the flowable polymer attaches said at least one disc replacement band to the end plates in flexible engagement.
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305. A method according to claim 293 wherein an intermediate band is formed in situ from a flowable polymer in a volume defined at least between inner surfaces of said at least one disc replacement band.
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306. A method according to claim 293 wherein an intermediate band is formed in situ from a flowable polymer in a volume defined at least in peripheral channels, having a undercut cross-sectional configuration, which are formed in said end plates, whereby the flowable polymer locks said at least one disc replacement band to the end plates in flexible engagement and said intermediate band retains said inflatable implant in position with said disc replacement band in surrounding engagement therewith.
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307. A method according to claim 293 wherein said at least one disc replacement band comprises at least two hollow bands and wherein body material from the nucleus pulposus is introduced under pressure to a volume intermediate adjacent end plates.
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222. A method according to claim 221, wherein said insertion employs a flat disc replacement coil transporter and dispenser.
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241. A method for performing spinal surgery comprising the steps of insertion and inflation of an integrated inflatable implant and pre-coiled lead between facing end plates of adjacent vertebrae.
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253. A method for performing spinal surgery comprising the step of winding a filament between facing end plates of adjacent vertebrae, thereby to provide a disc replacement coil.
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293. A method for insertion of an implant between end plates of respective adjacent vertebra comprising the steps of:
-
employing a pair of pick and place tools, each mounted on a surgical vehicle via a hand, to insert an inflatable implant between said end plates, said inflatable implant being partially deflated upon insertion thereof between said end plates;
employing an inflation tool, which is pre-attached to an outward end of a conduit in communication with a valve forming part of said inflatable implant to inflate said inflatable implant, thus causing expansion of the inflatable implant;
following inflation of the inflatable implant to a required extent, slidingly inserting batten bearing tools between adjacent end plates by means of forceps tools, such that edge protrusions of battens thereof lie in channels of respective end plates. thereafter, slightly deflating the inflatable implant, to an extent that the outer dimensions of the implant are decreased thereby tightly engaging said battens between respective end plates, thereby increasing the space between the inflatable implant and said battens, while said implant is still retained in an immobilized state between said end plates;
deflating said inflatable implant;
removing said inflatable implant from between respective end plates; and
inserting at least one disc replacement band between facing end plates of adjacent vertebrae, following removal of said inflatable implant.
-
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296. A method for insertion of an implant between end plates of respective adjacent vertebra comprising the steps of:
-
inserting an inflatable implant in a folded orientation and at least one disc replacement band coupled thereto between said end plates, said inflatable implant being partially deflated upon insertion thereof between said end plates; and
employing an inflation tool to inflate said inflatable implant, thus causing expansion of the inflatable implant.
-
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308. A method for performing spinal fusion comprising:
-
initially milling and machining at least one end plate of adjacent vertebrae to provide at least one generally straight channel extending from one edge of the end plate to a location adjacent an opposite edge thereof; and
inserting and placing a bone graft on at least one machined surface of at least one of said end plates in engagement with said channel. - View Dependent Claims (309, 310)
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309. A method for performing spinal fusion according to claim 308 wherein said method is carried out using endosurgical techniques.
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310. A method for performing spinal fusion according to claim 308 wherein the inserting and placing step includes enclosing a bone graft segment within a fiber sleeve, thereby providing a honeycomb structure.
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309. A method for performing spinal fusion according to claim 308 wherein said method is carried out using endosurgical techniques.
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311. A computer-controlled surgical implant system comprising:
-
at least one steerable endosurgical implanting assembly operative to install an implant at a desired location in a patient; and
a computerized controller operating the at least one steerable endosurgical implanting assembly. - View Dependent Claims (312, 313, 314, 315, 316, 317, 318, 319, 320, 321, 322, 323, 324, 325, 326, 327, 328, 329, 330, 331, 332, 333, 334, 335, 336, 337, 338, 339, 340, 341, 342, 343, 344, 345, 346, 347, 348, 349, 350, 351, 352, 353, 354, 355, 356, 357, 358, 359, 360, 361, 362, 363, 364, 365, 366, 367, 368, 369, 370, 371, 372, 373, 374, 375, 376, 377, 378, 379, 380, 381, 382, 383, 384, 385, 386, 387, 388, 389, 390, 391, 392, 393, 394, 395, 396, 397, 398, 399, 400, 401, 402, 403, 404, 405, 406, 407, 408, 409, 410, 411, 412, 413, 414, 415, 416, 417, 418, 419, 420, 421, 422, 423, 424, 425, 426, 427, 428, 429, 430, 431, 432, 433)
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312. A computer-controlled surgical implant system according to claim 311 wherein said at least one steerable endosurgical assembly comprises a multi-stage cannula assembly.
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313. A computer-controlled surgical implant system according to claim 311 wherein said at least one steerable endosurgical assembly comprises a multi-functional cannula assembly.
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314. A computer controlled surgical implant system according to claim 311 also comprising a tracking system for tracking the position of the endosurgical implanting assembly.
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315. A computer controlled surgical implant system according to claim 311 wherein said at least one steerable endosurgical implanting assembly provides an anchoring functionality for anchoring a cannula at a desired location.
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316. A computer controlled surgical implant system according to claim 311 also comprising a computer controlled patient support table.
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317. A computer controlled surgical implant system according to claim 312 also comprising a computer controlled patient support table.
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318. A computer controlled surgical implant system according to claim 316 wherein said computer controlled patient support table comprises:
-
a chest support portion;
a plurality of intermediate support elements, selectably positionable with respect to a longitudinal axis of said chest support portion to accommodate an existing or desired orientation of the patient; and
a lower body support portion having a longitudinal axis, which is angled with respect to said chest support portion by an angle, selected to accommodate an existing or desired orientation of the patient.
-
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319. A computer controlled surgical implant system according to claim 316 also comprising an equipment support base arranged to be mounted over the back of the patient onto said support table.
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320. A computer controlled surgical implant system according to claim 316, also including encoders to enable accurate patient repositioning on said patient support table.
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321. A computer controlled surgical implant system according to claim 319 wherein said at least one steerable endosurgical implanting assembly operative to install an implant at a desired location in a patient comprises a multifunctional surgical assembly including:
-
a universal mounting assembly which is secured to and supported by said equipment support base;
at least two drive assemblies, which are replaceably and modularly mountable onto said universal mounting assembly; and
a multifunctional cannula assembly, operative in association with said universal mounting assembly and with said at least two drive assemblies.
-
-
322. A computer controlled surgical implant system according to claim 321 wherein said multifunctional cannula assembly includes at least two different cannula subassemblies which are driven by respective ones of said at least two drive assemblies.
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323. A computer controlled surgical implant system according to claim 322 wherein said multifunctional surgical assembly includes a computerized operator interface.
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324. A computer controlled surgical implant system according to claim 321, wherein said universal mounting assembly comprises:
-
first mounting tracks which are removably attached to said equipment support base;
a carriage assembly, defining second mounting tracks and arranged for selectable and fixable positioning on said first mounting tracks;
a platform, arranged for selectable and fixable positioning onto said second mounting tracks; and
a cannula mounting assembly associated with said platform and onto which are mounted said first, second and third drive assemblies
-
-
325. A computer controlled surgical implant system according to claim 324
also comprising a real-time imaging assembly mounted onto said platform. -
326. A computer controlled surgical implant system according to claim 324, also comprising an array of RF receiving antennas which are used for sensing the precise orientation and position of elements of said multifunctional cannula subassembly.
-
327. A computer controlled surgical implant system according to claim 324 wherein said cannula mounting assembly comprises:
-
a base which is mounted onto said platform, said base including an upstanding portion and a protruding portion;
a spherical bearing mounted onto said protruding portion and including a central aperture through which first, second and third cannula subassemblies, which form part of said multifunctional cannula assembly, may slidably extend;
a selectably orientatable socket mounted on said spherical bearing for removably and replaceably receiving said first, second and third drive assemblies.
-
-
328. A computer controlled surgical implant system according to claim 327 wherein said selectably orientatable socket is selectably positionable in three dimensions by at least two pivotably mounted positioning pistons operated by a hydraulic driving controller.
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329. A computer controlled surgical implant system according to claim 328, wherein said at least two pivotably mounted positioning pistons are pivotably mounted onto a portion of said base by means of spherical mounting bearings and are attached to said socket by means of spherical mounting bearings.
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330. A computer controlled surgical implant system according to claim 327 also comprising first, second and third drive assemblies, each of which comprises a housing onto which is mounted a linear driving motor controlled by a linear driving controller, and a rotational driving motor controlled by a rotational driving controller.
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331. A computer controlled surgical implant system according to claim 330 wherein each linear driving motor is coupled to at least one driving roller, which drivingly engages a cannula subassembly for providing linear driving thereof and wherein each rotational driving motor is coupled to gearing, which drivingly engages said cannula subassembly for providing rotational driving thereof.
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332. A computer controlled surgical implant system according to claim 327 also comprising a pressurized fluid source having a plurality of pressurized fluid sockets mounted on said cannula mounting assembly.
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333. A computer controlled surgical implant system according to claim 327 also comprising a multifunctional controller which includes a plurality of electric power sockets and a plurality of electric control signal sockets, said multifunctional controller receiving electric control and power inputs from an operator interface.
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334. A computer controlled surgical implant system according to claim 333 also comprising a bidirectional information link between said multifunctional controller and various devices controlled thereby, such that at any given time, said controller is aware of the identity and operational status of each of the devices controlled thereby, for optimal control of the operation thereof.
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335. A computer controlled surgical implant system according to claim 321 wherein said multifunctional cannula assembly comprises first, second and third cannula subassemblies, which are generally coaxial.
-
336. A computer controlled surgical implant system according to claim 335 wherein said first cannula subassembly is steerable to a desired location in a patient'"'"'s anatomy.
-
337. A computer controlled surgical implant system according to claim 335
wherein said first cannula subassembly comprises: a central flexible core located within a flexible outer tube, said outer tube containing therewithin curvature control tendons which may be tensioned or compressed to effect desired curvature of the first cannula subassembly.
-
338. A computer controlled surgical implant system according to claim 337 wherein said first cannula subassembly also comprises:
-
a flexible shaft terminating in a anchor screw; and
at least one fiber optics link.
-
-
339. A computer controlled surgical implant system according to claim 335 wherein said first cannula subassembly also comprises a cover for the anchor screw which is formed of a material which is readily absorbed by the human body.
-
340. A computer controlled surgical implant system according to claim 338
wherein said shaft is rotatably located within a bore formed within said core. -
341. A computer controlled surgical implant system according to claim 337 also comprising tendons which are slidably disposed within respective elongate bores formed in said core.
-
342. A computer controlled surgical implant system according to claim 337 wherein said tendons are each anchored at a location adjacent a forward end of said first cannula subassembly and coupled at an opposite end thereof to a driving structure.
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343. A computer controlled surgical implant system according to claim 342 wherein said driving structure is formed with externally facing recesses to enable it to be readily engaged by an external driving member for linear driving thereof in a push-pull manner for applying tension or compression to the tendon fixed thereto.
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344. A computer controlled surgical implant system according to claim 343 wherein said driving structure is linearly slidably disposed in a recess formed in said core at a window formed in said outer tube.
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345. A computer controlled surgical implant system according to claim 337 also comprising at least one fiber optics link located in a suitable recess or bore formed in said core and extending to at least one optical sensor.
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346. A computer controlled surgical implant system according to claim 337 also comprising at least one fiber optics link located in a suitable recess or bore formed in said core and extending from an external light source to an illuminator.
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347. A computer controlled surgical implant system according to claim 337 wherein said first cannula subassembly also comprises at least one electrical conductor for supplying electrical power to at least one electrical signal beacon transducers which are sensible by at least one of the elements of a real time imaging assembly, thereby to enable the precise location and orientation of the first cannula subassembly to be ascertained and monitored.
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348. A computer controlled surgical implant system according to claim 337 wherein said first cannula subassembly also comprises an elongate low power RF transmitting antenna receiving an electrical signal from a suitable RF signal source such that its precise orientation may be readily sensed by antennas forming part of a real time imaging assembly.
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349. A computer controlled surgical implant system according to claim 337 wherein said first cannula subassembly also comprises an elongate recess formed along a majority of the length of the first cannula subassembly, said recess being engageable by a suitable protrusion connected to gearing for rotational driving of the first cannula subassembly.
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350. A computer controlled surgical implant system according to claim 335 wherein said second cannula subassembly is arranged to be inserted over said first cannula subassembly and has a larger cross-section than the first cannula subassembly.
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351. A computer controlled surgical implant system according to claim 350 wherein said second cannula subassembly comprises a plurality of sub-sub-assemblies, each of larger cross-section than its predecessor.
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352. A computer controlled surgical implant system according to claim 350 wherein said second cannula subassembly includes a conditioned easily grippable surface for enhancing ease of manipulation of the second cannula subassembly.
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353. A computer controlled surgical implant system according to claim 350 wherein said second cannula subassembly includes fiber optics connectors at the rearward end of the second cannula subassembly for fiber optics communication connections between fiber optics links, which communicate with optical sensors, and illuminators.
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354. A computer controlled surgical implant system according to claim 350 wherein said second cannula subassembly includes, adjacent a rearward end thereof, a slider, having a manual engagement portion, and a generally flat portion, having a forward end, said slider being slidably retained in said second cannula subassembly for longitudinal sliding motion relative thereto, into and out of operative engagement with a flexible engagement member.
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355. A computer controlled surgical implant system according to claim 354, wherein said flexible engagement member is formed of a resilient material and includes a mounting portion which is seated in a recess formed in the second cannula subassembly, an elongate portion and an inner facing protrusion portion, said flexible engagement member being mounted such that it is biased inwardly into engagement into a recess in the first cannula subassembly, when not displaced by the slider.
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356. A computer controlled surgical implant system according to claim 335 wherein said third cannula subassembly comprises tracks for transport of surgical equipment therealong to a surgical site in the patient'"'"'s anatomy and removal of body materials from the surgical site.
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357. A computer controlled surgical implant system according to claim 356 wherein said third cannula subassembly comprises:
-
at least one electrical power link; and
at least one fiber optics link.
-
-
358. A computer controlled surgical implant system according to claim 356 wherein said third cannula subassembly comprises piping for liquid transport, vacuum and gas pressure.
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359. A computer controlled surgical implant system according to claim 356 wherein said third cannula subassembly also includes a plurality of curvature control tendons.
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360. A computer controlled surgical implant system according to claim 336 comprising, in association with said first cannula subassembly, a steering subassembly comprising:
-
a housing onto which are mounted a drill driving assembly and a tendon tensioning and compressing assembly; and
a base which is mounted on said housing and which supports a fiber optic connector assembly.
-
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361. A computer controlled surgical implant system according to claim 360 wherein said tendon tensioning and compressing assembly comprises a plurality of pistons, corresponding in number to the number of tendons in said first cannula subassembly, each of said pistons operative for selectably tensioning or compressing an individual tendon.
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362. A computer controlled surgical implant system according to claim 361 wherein each of said plurality of pistons includes an at least partially flexible toothed shaft which is arranged to operatively engage recesses in driving structures for producing linear displacement thereof in recesses formed in said core for selectably tensioning or compressing individual tendons attached to each of the driving structures.
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363. A computer controlled surgical implant system according to claim 335 wherein said third cannula subassembly comprises:
-
an inner portion; and
an outer portion, said outer portion being selectably slidable with respect to the inner portion and comprising a generally cylindrical hollow element formed with a plurality of tracks.
-
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364. A computer controlled surgical implant system according to claim 363 wherein said plurality of tracks include a first plurality of inner facing tracks having a first cross-sectional configuration and a second plurality of inner facing tracks, having a cross-sectional configuration different from that of said first plurality of tracks.
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365. A computer controlled surgical implant system according to claim 364 wherein said plurality of tracks include a third plurality of inner facing tracks having a cross-sectional configuration different from that of said first and second pluralities of tracks and also having an undercut cross-section.
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366. A computer controlled surgical implant system according to claim 363 wherein said outer portion comprises at least one elongate bore having disposed therein an anchoring screw including a tapered thread at a forward end and an engagement head at a rearward end.
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367. A computer controlled surgical implant system according to claim 366, wherein said outer portion comprises, disposed in said at least one elongate bore, an elongate eye assembly, said elongate eye assembly including a visual sensor and an illuminator.
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368. A computer controlled surgical implant system according to claim 367 wherein said visual sensor is coupled, via a fiber optic link embedded in an elongate eye manipulating support, to utilization circuitry.
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369. A computer controlled surgical implant system according to claim 368 wherein said manipulating support is, in turn, operated by a drive assembly mounted on said outer portion, and by an eye directing assembly and is capable of linear displacement and rotation relative to said outer portion as well as directable bending.
-
370. A computer controlled surgical implant system according to claim 367 also comprising tendons disposed in bores formed in said outer portion, said tendons being employable for providing selectable bendability and directability to the third cannula subassembly.
-
371. A computer controlled surgical implant system according to claim 363, wherein said inner portion functions principally as a spacer for properly positioning the outer portion with respect to the second cannula subassembly and is designed to be removed prior to carrying out most of the functionality of the outer portion.
-
372. A computer controlled surgical implant system according to claim 361 wherein fiber optics connectors are provided at the rearward end of the third cannula subassembly for fiber optics communication between fiber optics links which communicate with optical sensors and illuminators.
-
373. A computer controlled surgical implant system according to claim 363 comprising a slider disposed adjacent a rearward end of the third cannula subassembly, said slider having a manual engagement portion and a generally flat portion, the flat portion having a forward end, the slider being slidably retained in third cannula subassembly for longitudinal sliding motion relative thereto, into and out of operative engagement with a flexible engagement member.
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374. A computer controlled surgical implant system according to claim 373 wherein said flexible engagement member is formed of a resilient material and includes a mounting portion which is seated in a recess formed said inner portion, an elongate portion and an inner facing protrusion portion, said flexible engagement member being mounted such that it is biased inwardly into engagement with a recess in the second cannula subassembly, when not displaced by the slider.
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375. A computer controlled surgical implant system according to claim 373 also comprising a locking pin, associated with said outer portion, which selectably engages a recess formed in said inner portion for preventing linear motion therebetween prior to intended removal of the inner portion from the outer portion.
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376. A computer controlled surgical implant system according to of claim 369 wherein said drive assembly comprises a housing onto which is mounted a linear driving motor which is controlled by a linear driving controller, said driving motor being coupled to at least one driving roller, which drivingly engages eye manipulating support.
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377. A computer controlled surgical implant system according to claim 376 wherein said drive assembly also comprises a rotational driving motor, which is controlled by a rotational driving controller, said rotational driving motor being coupled to gearing, which drivingly engages said eye manipulating support for providing rotational driving thereof.
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378. A computer controlled surgical implant system according to claim 363 wherein said eye directing assembly comprises a housing onto which is mounted a tendon tensioning and compressing assembly and has an output which is coupled to an operator visualization subsystem.
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379. A computer controlled surgical implant system according to claim 367 wherein said elongate eye assembly includes a plurality of visual sensors surrounding an illuminator.
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380. A computer controlled surgical implant system according to claim 335, comprising at least one self-propelled surgical vehicle associated with said third cannula subassembly.
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381. A computer controlled surgical implant system according to claim 380, wherein said at least one self-propelled surgical vehicle comprises:
-
a body of generally uniform cross-section having a longitudinal bore and defining forward and rearward faces;
at least two freely rolling rollers mounted on said body; and
a driving roller, which is powered by an electric motor, disposed within said body.
-
-
382. A computer controlled surgical implant system according to claim 380
wherein said at least one self-propelled surgical vehicle comprises a quick connection mounting assembly located at at least one of said forward and rearward faces at said bore. -
383. A computer controlled surgical implant system according to claim 382 wherein said forward face of the body is formed with a plurality of recesses which are employed for assisting in the mounting of hands onto the vehicle.
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384. A computer controlled surgical implant system according to claim 381 wherein said body is formed with a pair of longitudinal recesses which extend along edges of the body in parallel to said bore and in which are disposed said at least two freely rolling rollers.
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385. A computer controlled surgical implant system according to claim 384, wherein said driving roller is disposed in one of said pair of longitudinal recesses.
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386. A computer controlled surgical implant system according to claim 381 wherein said at least two freely rotating rollers roll along at least one track formed in said third cannula subassembly and said driving roller drivingly engages cogs formed along at least another track formed in said third cannula subassembly for precision longitudinal positioning of the vehicle along said tracks.
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387. A computer controlled surgical implant system according to claim 381 wherein said electric motor is controlled by a multifunctional controller via a control cable which extends through said outer portion of said third cannula subassembly.
-
388. A computer controlled surgical implant system according to claim 381 wherein said electric motor receives electrical power from said multifunctional controller via a power cable extending from an electric power socket which is removably coupled to a socket formed on said rearward face.
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389. A computer controlled surgical implant system according to claim 381 wherein auxiliary electrical power is provided for hands attached to the forward face by means of an auxiliary power cable which is removably coupled to a socket formed on said rearward face and extends through said longitudinal bore.
-
390. A computer controlled surgical implant system according to claim 381 wherein auxiliary electrical control is provided for hands attached to the forward face by means of an auxiliary control cable which is removably coupled to a socket formed on said rearward face and which extends through said longitudinal bore.
-
391. A computer controlled surgical implant system according to claim 390 wherein auxiliary electrical control is provided to said socket for said hands attached to said forward face by means of an auxiliary control cable which is removably coupled to a socket formed on said rearward face, extends through the outer portion of the third cannula subassembly and is connected to a control signal socket of a multifunctional controller.
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392. A computer controlled surgical implant system according to claim 381 wherein said vehicle has cross-sectional dimensions which do not exceed 20 mm.
-
393. A computer controlled surgical implant system according to claim, 381 wherein said body is formed with a throughgoing bore for accommodating an eye manipulating support.
-
394. A computer controlled surgical implant system according to claim 381 wherein said body is formed with a pair of longitudinal recesses which extend along edges of the body in parallel to said bore and in which are disposed said at least two freely rolling rollers and a third longitudinal recess along which are disposed at least one freely rolling roller and a driving roller, which is powered by an electric motor disposed within said body.
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395. A computer controlled surgical implant system according to claim 394, wherein said third longitudinal recess is formed at its ends with a cross-sectional configuration defining an undercut which maintains operative engagement between said at least one freely rolling roller, said driving roller and said track and thus enables said vehicle to ride on said single track.
-
396. A computer controlled surgical implant system according to claim 394, wherein said at least one freely rolling roller rolls along said track, while said driving roller drivingly engages cogs on said track for precision longitudinal positioning of the vehicle therealong.
-
397. A computer controlled surgical implant system according to claim 396 wherein said vehicle has cross-sectional dimensions which do not exceed 16 mm.
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398. A computer controlled surgical implant system according to claim 381 wherein said body is formed with a longitudinal recess defining forward and rearward faces onto which are formed quick connectors, peripherally of said recess and wherein at least one freely rolling roller and a driving roller, powered by an electric motor are disposed within said body.
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399. A computer controlled surgical implant system according to claim 398, wherein said longitudinal recess is formed at its ends with a cross-sectional configuration defining an undercut which maintains operative engagement between said at least one freely rolling roller and said driving roller and said track and thus enables said vehicle to ride on said single track.
-
400. A computer controlled surgical implant system according to claim 399 wherein said at least one freely rolling roller rolls along said track, while said driving roller drivingly engages cogs on said track for precision longitudinal positioning of the vehicle therealong.
-
401. A computer controlled surgical implant system according to claim 399 wherein said vehicle has cross-sectional dimensions which do not exceed 10 mm.
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402. A computer controlled surgical implant system according to claim 335 comprising at least one non self-propelled surgical vehicle.
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403. A computer controlled surgical implant system according to claim 402 wherein said at least one non self-propelled surgical vehicle comprises an elongate flexible element having a forward face and a rearward face and a generally uniform cross-sectional configuration including an undercut which maintains operative engagement between the vehicle and a track on said third cannula subassembly.
-
404. A computer controlled surgical implant system according to claim 403 wherein said at least one non self-propelled surgical vehicle is translated along tracks of said third cannula subassembly by an electric motor external of said vehicle.
-
405. A computer controlled surgical implant system according to claim 402 wherein a quick connector is provided on at least one elongate surface of each vehicle for connection thereto of hands.
-
406. A computer controlled surgical implant system according to claim 367 also comprising a universal hand which is employed in association with said at least one surgical vehicle, said universal hand including:
-
a base, which is removably coupled to a surgical vehicle;
a first intermediate element rotatable relative to said base about a longitudinal axis in said base by an electric motor;
a second intermediate element rotatable relative to said first intermediate element by an electric motor;
at least one additional intermediate element rotatable relative to said second intermediate element by an electric motor; and
a tool engagement element rotatable relative to said at least one additional intermediate element by an electric motor.
-
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407. A computer controlled surgical implant system according to claim 406 wherein said at least one additional intermediate element comprises at least first and second additional intermediate elements, which are rotatable relative to each other.
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408. A computer controlled surgical implant system according to claim 406 wherein a plurality of said vehicles is simultaneously operated with a plurality of hands.
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409. A computer controlled surgical implant system according to claim 408 wherein four said vehicles and four hands are simultaneously employed.
-
410. A computer controlled surgical implant system according to claim 406 comprising at least one tool mounted on said tool engagement element.
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411. A computer controlled surgical implant system according to claim 410 wherein said at least one tool is selected from the following tools:
- a milling head, a forceps tool, a forceps finger, an fluid dispenser tool, a pick and place tool, an articulated element, an inflation tool, a gauging tool, and a cutting tool.
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412. A computer controlled surgical implant system according to claim 335 also comprising a staging assembly employable in setting up and connecting tools and hands together with surgical vehicles, said staging assembly comprising:
a pair of end mounts, which are fixedly joined together by an elongate base element, which defines an inner facing surgical vehicle support track, which is alignable with a track in said third cannula subassembly, said end mounts defining seats for removably and securably receiving respective inner facing surgical vehicle support track defining members which are alignable with tracks in said third cannula subassembly.
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413. A computer controlled surgical implant system according to claim 335 also comprising a staging complex comprising a plurality of staging assemblies and being operative for modularly connecting various pieces of surgical equipment together and mounting them onto surgical vehicles.
-
414. A computer controlled surgical implant system according to claim 413 wherein at least one of said plurality of staging assemblies comprises:
a pair of end mounts, fixedly joined together by an elongate base element which defines an inner facing surgical vehicle support track, which track is alignable with a track in said third cannula subassembly, said end mounts defining seats for removably and securably receiving respective inner facing surgical vehicle support track defining members which are alienable with tracks in said third cannula subassembly.
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415. A computer controlled surgical implant system according to claim 412 wherein said end mounts are of generally open octagonal configuration and are fixedly joined together by an elongate base element, which defines an inner facing surgical vehicle support track, which is alignable with a track in the third cannula subassembly.
-
416. A computer controlled surgical implant system according to claim 412 wherein said end mounts each define seats for removably and securably receiving inner facing surgical vehicle support track defining members.
-
417. A computer controlled surgical implant system according to claim 412
wherein retaining pins are provided for removable engagement with sockets formed in at least one of said end mounts for engagement with corresponding sockets formed in ends of support track defining members, thereby to retain the track defining members in engagement with their respective seats. -
418. A computer controlled surgical implant system according to claim 412 wherein one of said end mounts is provided with an inner socket which is configured to receive a flange of said outer portion of said third cannula subassembly in such a manner that the vehicle support track defining members of the staging assembly are properly aligned with the respective inner facing tracks of said outer portion.
-
419. A computer controlled surgical implant system according to claim 418 wherein said socket and said corresponding flange are formed to have somewhat angled walls thereby to provide designed mutual mating thereof.
-
420. A computer controlled surgical implant system according to claim 419 also comprising a retaining pin engaging a socket in an end mount and a corresponding socket in a corresponding flange, thereby to retain the flange in mating engagement with the socket.
-
421. A computer controlled surgical implant system according to claim 412 wherein surgical vehicles, hands and tools are mounted onto a track defining member prior to attachment of the track defining member onto said end mounts.
-
422. A computer controlled surgical implant system according to claim 311 wherein said computerized controller also comprises an operator interface comprising:
-
an operator support seat assembly; and
a plurality of control elements, arranged in an arc so as to be readily engageable by an operator seated on said seat assembly, said plurality of control elements including visualization rotation control elements;
at least one visualization zoom control element, forward and rearward drive elements and a brake element, useful for governing operation of first second and third cannula subassemblies, surgical vehicles and hands associated therewith.
-
-
423. A computer controlled surgical implant system according to claim 422, wherein said operator interface also comprises:
-
a display coupled to a computer which contains at least patient imaging data and operation planning data; and
a least one computer input device.
-
-
424. A computer controlled surgical implant system according to claim 422
wherein said operator interface also comprises virtual reality apparatus. -
425. A computer controlled surgical implant system according to claim 422 wherein said operator interface comprises:
-
an operator visualization subsystem; and
an operator-controlled driving subsystem, said operator-controlled driving subsystem and said operator visualization subsystem being operative together.
-
-
426. A computer controlled surgical implant system according to claim 425 wherein said operator visualization subsystem receives inputs from at least three of the following elements:
- a computer, a real time imaging assembly, optical sensors, a keyboard, a mouse, a joystick and a hand interface.
-
427. A computer controlled surgical implant system according to claim 425
wherein said operator visualization subsystem provides outputs to at least one of illuminators, monitors and virtual reality equipment. -
428. A computer controlled surgical implant system according to claim 425 wherein said operator-controlled driving subsystem is operable to interactively interface with said operator visualization subsystem and also to receive inputs from at least one of the following elements:
- a computer;
control pedals;
a keyboard;
a mouse;
a joystick;
a hand interface;
audio inputs from a headset and hand and tool identification and orientation inputs from a multifunctional controller.
- a computer;
-
429. A computer controlled surgical implant system according to claim 425 wherein said operator-controlled driving subsystem provides outputs to controllers.
-
430. A computer controlled surgical implant system according to claim 425 wherein said operator support seat assembly comprises a fixed base, selectably vertically raisable and lowerable leg portions having leg portions fixedly attached thereto, a back and head support, a seat, which is swivelable in a generally horizontal plane about a vertical axis and adjustably fixable arm supports.
-
431. A computer controlled surgical implant system according to claim 430 wherein said operator interface also comprises a plurality of foot control pedals which are arranged about a vertical axis so as to be readily engageable by an operator seated on said seat who swivels the seat appropriately, said plurality of foot control pedals including clockwise and counterclockwise visualization rotation control pedals, a visualization zoom control pedal, forward and rearward drive pedals and a brake pedal, said foot control pedals being operative to govern translation of said first, second and third cannula subassemblies, and said surgical vehicles.
-
432. A computer controlled surgical implant system according to claim 424 wherein said virtual reality apparatus is operable to provide to an operator a sense that his hands are located within a region between adjacent vertebra at which the operation is taking place and are able to accurately manipulate various hands, within that region.
-
433. A computer controlled surgical implant system according to claim 424 wherein said virtual reality apparatus is operable to provide to an operator a view of the patient'"'"'s spine having no necessary relationship with the actual orientation of the patient'"'"'s spine.
-
312. A computer-controlled surgical implant system according to claim 311 wherein said at least one steerable endosurgical assembly comprises a multi-stage cannula assembly.
-
-
434. A tool for use in association with a hand and comprising:
-
a quick connection mounting assembly for connection to a hand; and
a pair of elements, having respective inwardly facing surfaces which are configured to correspond to the cross-sectional configuration of a main portion of a coil.
-
-
435. A tool for use in association with a hand and comprising:
-
a quick connection mounting assembly for connection to a hand;
a pair of elements having respective inwardly facing surfaces which are configured to define a coil coating passage having a cross-section corresponding to the cross-sectional configuration of the main portion of a coil;
a liquid coating supply conduit, which communicates with outlet orifices, formed on at least one coil surface for supplying a liquid coating material to a coil as the coil passes therethrough. - View Dependent Claims (436, 437)
-
436. A tool for use in association with a hand according to claim 435 wherein said liquid coating material is an in situ polymerizable polymer which, when polymerized, becomes an elastomeric bond substance.
-
437. A tool for use in association with a hand according to claim 436 wherein said liquid coating material is a flowable polyurethane.
-
436. A tool for use in association with a hand according to claim 435 wherein said liquid coating material is an in situ polymerizable polymer which, when polymerized, becomes an elastomeric bond substance.
-
-
438. A tool for use in association with a hand and comprising:
-
a quick connection mounting assembly for connection to a hand;
a base onto which is fixedly mounted a first forceps finger pair and a guiding finger; and
a second forceps finger pair, mounted for selectable positioning with respect to said first forceps finger pair.
-
-
439. A tool for use in association with a hand and comprising:
-
a quick connection mounting assembly for connection to a hand; and
a laser couplable to an energy outlet by means of an optical fiber assembly.
-
-
440. A tool for use in association with a hand and comprising:
a rigid element defining an inner facing channel on a concave surface thereof which matches a cross-sectional configuration of a coiled lead of an inflatable implant, for placement of the implant in a recess, without disturbing the arrangement of the coils of said coiled lead.
-
441. A coil winding assistance tool for use with a hand and comprising:
-
a base;
an arm attached at an end thereof to said base;
an outwardly extending finger and a transversely extending thumb disposed at an end of said arm, opposite to the end of said arm which is attached to said base, said finger and said thumb being configured to cooperate with a socket on a coil for assisting in the winding thereof.
-
-
442. An inflator tool for use with a hand and comprising:
-
an output nozzle; and
a flexible fluid supply tube for receiving a pressurized fluid input from a pressurized fluid source and providing a desired supply of fluid to said output nozzle. - View Dependent Claims (443)
-
443. An inflator tool according to claim 442 being formed with a grooved portion which is configured so as to enable it to be readily grasped by a forceps tool.
-
443. An inflator tool according to claim 442 being formed with a grooved portion which is configured so as to enable it to be readily grasped by a forceps tool.
-
-
444. A multifunctional coil orienting and coating &
- pick and place tool comprising;
a base;
a body portion extending from said base; and
an arm extending outwardly from said body portion in a curved manner and having a rounded tip. - View Dependent Claims (445, 446, 455, 456, 457, 458, 459, 460, 461, 462, 463, 464, 465, 466, 467, 468, 469, 470, 471, 472, 473, 475, 476, 477, 478, 479, 480, 481, 482, 483, 484, 485, 486, 487, 488, 489, 490, 491, 492, 494, 495, 496, 497, 498, 499, 500, 501, 502, 503, 504, 508, 509, 510, 511)
-
445. A multifunctional coil orienting and coating &
- pick and place tool according to claim 444 also comprising;
a spur element, disposed on a back surface of said arm and being configured to cooperate with a socket on a coil for assisting in the winding thereof.
- pick and place tool according to claim 444 also comprising;
-
446. A multifunctional coil orienting and coating &
- pick and place tool according to claim 445 also comprising a coil coating passage for supplying a liquid coating material to the coil as the coil passes therethrough.
-
455. A flat disc replacement coil transporter and dispenser according to claim 454
wherein said housing includes first and second generally elongate joined housing subassemblies. -
456. A flat disc replacement coil transporter and dispenser according to claim 454
wherein said plurality of mutually articulated portions are joined by flexible couplings. -
457. A flat disc replacement coil transporter and dispenser according to claim 455
wherein each of said housing subassemblies includes three housing sub-portions. -
458. A flat disc replacement coil transporter and dispenser according to claim 454 wherein said plurality of mutually articulated portions includes a forward facing housing portion which comprises a forward coil driving assembly including an electric motor operable to drive a roller, and wherein said roller forms part of a pinch roller assembly.
-
459. A flat disc replacement coil transporter and dispenser according to claim 458
wherein said pinch roller assembly includes rollers having cross-sections which correspond to the cross-sectional configurations of both a lead portion and a main portion of a flat disc coil. -
460. A flat disc replacement coil transporter and dispenser according to claim 458 wherein said forward facing housing portion comprises a coil feeder operable to feed a flat coil into driving engagement with said forward coil driving assembly.
-
461. A flat disc replacement coil transporter and dispenser according to claim 460,
wherein said coil feeder has a general configuration of a funnel. -
462. A flat disc replacement coil transporter and dispenser according to claim 454 also comprising at least one quick connection mounting assembly which is suitable for mounting of a hand onto said housing.
-
463. A flat disc replacement coil transporter and dispenser according to claim 454 also comprising a coil outlet aperture located on a front face of said housing.
-
464. A flat disc replacement coil transporter and dispenser according, to claim 463
wherein said coil outlet aperture is defined by respective front faces of said first and second housing sub-portions. -
465. A flat disc replacement coil transporter and dispenser according to claim 454 also comprising at least one vehicle dock for removable docking thereto of a surgical vehicle.
-
466. A flat disc replacement coil transporter and dispenser according to claim 454 also comprising an intermediate housing portion having an intermediate coil driving assembly.
-
467. A flat disc replacement coil transporter and dispenser according to claim 466
wherein said intermediate housing portion also includes an intermediate coil feeder, operable to feed a coil into driving engagement with said intermediate coil driving assembly. -
468. A flat disc replacement coil transporter and dispenser according to claim 454 also comprising a rearward housing portion, which includes a coil storage bay for storage of a coil in a coiled orientation therein.
-
469. A flat disc replacement coil transporter and dispenser according to claim 454 being configured so as not to fill all of the space in the third cannula subassembly and not to engage all of the tracks, whereby sufficient room is left free inside the third cannula subassembly to enable operation of a surgical vehicle, supported on at least one track thereof, alongside said flat disc replacement coil transporter and dispenser.
-
470. A flat disc replacement coil transporter and dispenser according to claim 454 which is configured to define a plurality of longitudinal recesses for mounting engagement with respective tracks of an outer portion of a third cannula subassembly.
-
471. A flat disc replacement coil transporter and dispenser according to claim 454 also comprising a winch.
-
472. A flat disc replacement coil transporter and dispenser according to claim 454 also comprising a driving belt driven by a sprocket drive assembly.
-
473. A flat disc replacement coil transporter and dispenser according to claim 472
wherein said sprocket drive assembly comprises a motor, and a sprocket driven by said motor, which is operative to drive said driving belt, via a plurality of fairleads. -
475. A cannula system according to claim 474 wherein said steerable cannula assembly comprises:
-
at least one steerable cannula;
a cannula steering assembly removably associated with said at least one steerable cannula.
-
-
476. A cannula system according to claim 475 wherein said at least one steerable cannula comprises a multi-stage cannula assembly.
-
477. A cannula system according to claim 475 wherein said at least one steerable cannula comprises a multi-functional cannula assembly.
-
478. A cannula system according to claim 475 also comprising a tracking system for tracking the position of said at least one steerable cannula.
-
479. A cannula system according to claim 475 wherein said at least one steerable cannula assembly comprises a cannula insertion assembly which is operative to insert at least one cannula into a patient at a desired location and a desired angle.
-
480. A cannula system according to claim 479 wherein said cannula insertion assembly includes:
-
a universal mounting assembly;
at least two drive assemblies, which are replaceably and modularly mountable onto said universal mounting assembly; and
a multifunctional cannula assembly, operative in association with said universal mounting assembly and with said at least-two drive assemblies.
-
-
481. A cannula system according to claim 480 wherein said multifunctional cannula assembly includes at least two different cannula subassemblies which are driven by respective ones of said at least two drive assemblies.
-
482. A cannula system according to claim 480 wherein said multifunctional surgical assembly includes a computerized operator interface.
-
483. A cannula system according to claim 480 wherein said universal mounting assembly comprises:
a cannula mounting assembly onto which are mounted said at least two drive assemblies.
-
484. A cannula system according to claim 480 also comprising a real-time imaging assembly.
-
485. A cannula system according to claim 480 also comprising an array of RF receiving antennas which are used for sensing the precise orientation and position of elements of said multifunctional cannula subassembly.
-
486. A cannula system according to claim 483 wherein said cannula mounting assembly comprises:
-
a spherical bearing including a central aperture through which at least one cannula subassembly, which forms part of said multifunctional cannula assembly, may slidably extend; and
a selectably orientatable socket mounted on said spherical bearing for removably and replaceably receiving said at least two drive assemblies.
-
-
487. A cannula system according to claim 486 wherein said selectably orientatable socket is selectably positionable in three dimensions by at least two pivotably mounted positioning pistons operated by a hydraulic driving controller.
-
488. A cannula system according to claim 480 wherein each of said at least two drive assemblies comprises a housing onto which is mounted firstly a linear driving motor controlled by a linear driving controller, and secondly a rotational driving motor controlled by a rotational driving controller.
-
489. A cannula system according to claim 474 wherein said at least one steerable cannula subassembly comprises:
a central flexible core located within a flexible outer tube, said outer tube containing therewithin curvature control tendons operable to be tensioned or compressed to effect desired curvature of the at least one steerable cannula subassembly.
-
490. A cannula system according to claim 489 wherein said tendons are slidably disposed within respective elongate bores formed in said core and are removably couplable to a drive assembly for linear driving of said tendons in a push-pull manner for applying tension or compression to the tendon fixed thereto.
-
491. A cannula system according to claim 489, wherein said at least one steerable cannula assembly also comprises at least one electrical conductor for supplying electrical power to at least one electrical signal beacon transducers which are sensible by at least one of the elements of a real time imaging assembly, thereby to enable the precise location and orientation of said at least one steerable cannula subassembly to be ascertained and monitored.
-
492. A cannula system according to claim 474 wherein said at least one steerable cannula assembly also comprises an elongate recess formed along a majority of the length of a cannula, said recess being engageable by a suitable protrusion connected to gearing for rotational driving of the cannula.
-
494. A self-propelled surgical vehicle according to claim 493 also comprising a quick connection mounting assembly located at at least one of said forward and rearward faces of said body.
-
495. A self-propelled surgical vehicle according to claim 493 wherein said forward face of the body is formed with a plurality of recesses which are employable for assisting in the mounting of auxiliary elements onto the vehicle.
-
496. A self-propelled surgical vehicle according to claim 493 wherein said body is formed with at least one longitudinal recess which extends along edges of the body and in which is disposed said at least one freely rolling rollers.
-
497. A self-propelled surgical vehicle according to claim 496 and wherein said driving roller is disposed in said at least one longitudinal recess.
-
498. A self-propelled surgical vehicle according to claim 493 wherein said at least one freely rotating roller is operable to roll along at least one track formed in a cannula and said driving roller is operable to drivingly engage cogs formed along at least another track formed in said cannula for precision longitudinal positioning of the vehicle along said tracks.
-
499. A self-propelled surgical vehicle according to claim 493 wherein said electric motor is controlled by a multifunctional controller via a control cable;
- which extends through said cannula.
-
500. A self-propelled surgical vehicle according to claim 493 wherein auxiliary electrical power is providable for auxiliary elements attached to the forward face by means of an auxiliary power cable which is removably couplable to a socket formed on said rearward face.
-
501. A self-propelled surgical vehicle according to claim 493 wherein auxiliary electrical control is provided for said auxiliary elements attachable to said forward face by means of an auxiliary control cable which is removably couplable to said rearward face and extendable through said cannula.
-
502. A self-propelled surgical vehicle according to claim 493 wherein said body is formed with a throughgoing bore.
-
503. A self-propelled surgical vehicle according to claim 493 wherein said body is formed with a pair of longitudinal recesses which extend along edges of the body and in which are disposed said at least two freely rolling rollers and a third longitudinal recess along which are disposed at least one freely rolling roller and a driving roller, said driving roller being powerable by an electric motor disposed within said body.
-
504. A self-propelled surgical vehicle according to claim 503 wherein said third longitudinal recess is formed at its ends with a cross-sectional configuration defining an undercut which maintains operative engagement between said at least one freely rolling roller and said driving roller and said track and thus enables said vehicle to ride on said single track.
-
508. A surgical vehicle according to claim 493 also comprising a universal hand which is employable in association with said surgical vehicle, said universal hand including:
-
a base, which is removably coupled to said surgical vehicle, at least first and second intermediate elements rotatable relative to said base about a longitudinal axis in said base by an electric motor and including a tool engagement element.
-
-
509. A plurality of surgical vehicle according to claim 493 also comprising universal hands employable in association with said surgical vehicles, at least one of said universal hands including:
-
a base, which is removably coupled to one of said surgical vehicles;
at least first and second intermediate elements rotatable relative to said base about a longitudinal axis in said base by an electric motor and including a tool engagement element.
-
-
510. A surgical vehicle according to claim 508 and comprising at least one tool mounted on said tool engagement element.
-
511. A surgical vehicle according to claim 510, wherein said at least one tool is selected from the following tools:
- a milling head, a forceps tool, a forceps finger, an fluid dispenser tool, a pick and place tool, an articulated element, an inflation tool, a gauging tool, and a cutting tool.
-
445. A multifunctional coil orienting and coating &
- pick and place tool comprising;
-
447. A coil bonding adhesive curing tool comprising:
-
a base, which is arranged to be coupled to a tool engagement element of a hand;
an arm, extending outwardly from said base in a curved manner; and
an ultraviolet light output device, mounted on an outward end of said arm.
-
-
448. A multifunctional disc replacement band orienting tool comprising a base portion having integrally formed therewith a flexible batten having edge protrusions which correspond in cross-section to cross-sections of channels formed in facing end plates.
-
449. A forceps tool comprising a base onto which are fixedly mounted first and second forceps fingers, said second forceps finger being mounted for selectable positioning with respect to said first forceps finger, said tool being characterized in that respective mutually facing surfaces of said first and second forceps fingers are formed with a protrusion and a cooperating and correspondingly positioned and configured engagement surface.
-
450. A disc replacement band engagement tool comprising
a base, and an arm extending outwardly from said base and terminating in a rounded tip, there being formed, along opposite side surfaces of said arm, pairs of protrusions which are adapted for operative engagement with retaining sockets.
-
451. A disc replacement band engagement tool comprising
a base, and a bent arm extending outwardly from said base and terminating in a cylindrical pin, said pin being adapted for engagement with at least one aperture formed on said band.
-
452. A tool operable for supplying a flowable polymer to a disc replacement band and comprising a base and at least first and second nozzles, said first nozzle being coupled to a conduit which receives a pressurized supply of flowable polymer, said first nozzle thus supplying said polymer via outlets to an interior of said band, and said second nozzle being connected at another location at the interior of said band and applying negative pressure thereto.
-
453. A tool operable for inserting an inflatable implant retained in a folded orientation, said tool comprising a base portion including a mounting aperture which is arranged to be engaged by the tool and having integrally formed therewith a generally cylindrical retaining portion.
-
454. A flat disc replacement coil transporter and dispenser including a housing, comprising a plurality of mutually articulated portions and enclosing at least one coil driving assembly including an electric motor which drives a roller engaging a disc replacement coil and a coil feeder which feeds said coil into driving engagement with said coil driving assembly.
-
474. A cannula system comprising:
-
at least one steerable cannula assembly; and
a controller operating the at least one steerable cannula assembly.
-
-
493. A self-propelled surgical vehicle comprising:
-
a body of generally uniform cross-section and defining forward and rearward faces;
at least one freely rolling roller mounted on said body; and
a driving roller, powerable by an electric motor, disposed within said body.
-
-
505. A non-self-propelled surgical vehicle comprising at least one element having a generally uniform cross-sectional configuration, including an undercut, and which is operable to maintain operative engagement between the vehicle and a track on a cannula.
- View Dependent Claims (506, 507)
-
506. A non-self-propelled surgical vehicle according to claim 505 wherein said at least one element is adapted to be translated along said track by an external electric motor.
-
507. A non-self-propelled surgical vehicle according to claim 505
also comprising a quick connector located on at least one surface of each said at least one element for connection thereto of at least one auxiliary element.
-
506. A non-self-propelled surgical vehicle according to claim 505 wherein said at least one element is adapted to be translated along said track by an external electric motor.
-
512. A method of treating scoliosis comprising the steps of inserting a disc replacement coil intermediate adjacent vertebra.
- View Dependent Claims (513)
-
513. A method of treating scoliosis according to claim 512, wherein said disc replacement coil is in the form of a wedge which is attached at a seat and secured to at least one vertebra end plate.
-
513. A method of treating scoliosis according to claim 512, wherein said disc replacement coil is in the form of a wedge which is attached at a seat and secured to at least one vertebra end plate.
Specification
- Resources
-
Current AssigneeNuvasive Incorporated
-
Original AssigneeDiscure Ltd.
-
InventorsSteinberg, Amiram
-
Granted Patent
-
Time in Patent OfficeDays
-
Field of Search
-
US Class Current623/17.12
-
CPC Class CodesA61B 17/00234 for minimally invasive surg...A61B 17/1631 Special drive shafts, e.g. ...A61B 17/1671 for the spineA61B 17/1757 for the spineA61B 17/29 Forceps for use in minimall...A61B 2017/00261 DiscectomyA61B 2017/1602 MillsA61B 2034/104 Modelling the effect of the...A61B 2034/105 Modelling of the patient, e...A61B 2034/107 Visualisation of planned tr...A61B 2034/742 JoysticksA61B 34/10 Computer-aided planning, si...A61B 34/30 Surgical robotsA61B 34/70 Manipulators specially adap...A61B 6/506 for diagnosis of nervesA61B 90/11 with guides for needles or ...A61B 90/14 Fixators for body parts, e....A61F 2/08 Muscles; Tendons; Ligaments...A61F 2/28 Bones joints A61F2/30A61F 2/30742 Bellows or hose-like seals;...A61F 2/30749 : Fixation appliances for con...A61F 2/30767 : Special external or bone-co...A61F 2/30965 : Reinforcing the prosthesis ...A61F 2/32 : for the hipA61F 2/36 : Femoral heads ; Femoral end...A61F 2/3601 : for replacing only the epip...A61F 2/3662 : Femoral shaftsA61F 2/38 : for elbows or kneesA61F 2/44 : for the spine, e.g. vertebr...A61F 2/441 : made of inflatable pockets ...A61F 2/4455 : for the fusion of spinal bo...A61F 2/4609 : of acetabular cupsA61F 2002/2835 : Bone graft implants for fil...A61F 2002/30009 : differing in fibre orientat...A61F 2002/30014 : differing in elasticity, st...A61F 2002/30062 : (bio)absorbable, biodegrada...A61F 2002/3007 : Coating or prosthesis-cover...A61F 2002/30133 : kidney-shaped or bean-shapedA61F 2002/30136 : undulated or wavy, e.g. ser...A61F 2002/30156 : triangularA61F 2002/30197 : Omega-shapedA61F 2002/30242 : sphericalA61F 2002/30289 : helically-coiledA61F 2002/30354 : Cylindrically-shaped protru...A61F 2002/30369 : Limited lateral translation...A61F 2002/3037 : Translation along the commo...A61F 2002/30383 : made by laterally inserting...A61F 2002/30398 : SlidingA61F 2002/30426 : Bayonet couplingA61F 2002/30448 : using adhesivesA61F 2002/305 : Snap connectionA61F 2002/30515 : using a locking wedge or blockA61F 2002/30563 : having elastic means or dam...A61F 2002/30574 : with an integral complete o...A61F 2002/30579 : with mechanically expandabl...A61F 2002/30581 : having a pocket filled with...A61F 2002/30593 : hollowA61F 2002/30594 : slotted, e.g. radial or mer...A61F 2002/30599 : stackableA61F 2002/30604 : modularA61F 2002/30639 : having rolling elements bet...A61F 2002/30642 : having a single rolling (or...A61F 2002/30652 : Special cut-outs, e.g. flat...A61F 2002/30662 : with rotation-limiting meansA61F 2002/30673 : Lubricating means, e.g. syn...A61F 2002/30733 : Inserts placed into an endo...A61F 2002/30777 : Oblong aperturesA61F 2002/30795 : Blind bores, e.g. of circul...A61F 2002/3082 : GroovesA61F 2002/30878 : with non-sharp protrusions,...A61F 2002/30879 : RibsA61F 2002/30884 : Fins or wings, e.g. longitu...A61F 2002/30919 : SleevesA61F 2002/30934 : Special articulating surfacesA61F 2002/30971 : Laminates, i.e. layered pro...A61F 2002/30973 : Two joined adjacent layers ...A61F 2002/3208 : Bipolar or multipolar joint...A61F 2002/3216 : tripolarA61F 2002/3412 : with pins or protrusions, e...A61F 2002/3429 : with an integral peripheral...A61F 2002/3611 : Heads or epiphyseal parts o...A61F 2002/3613 : with lateral or oblique ape...A61F 2002/3631 : with an integral complete o...A61F 2002/3652 : Connections of necks to shaftsA61F 2002/3694 : with longitudinal boresA61F 2002/448 : comprising multiple adjacen...A61F 2002/4619 : for extractionA61F 2002/4632 : using computer-controlled s...A61F 2002/4635 : using minimally invasive su...A61F 2210/0004 : bioabsorbableA61F 2220/0008 : Fixation appliances for con...A61F 2220/0025 : Connections or couplings be...A61F 2220/0033 : made by longitudinally push...A61F 2220/005 : using adhesivesA61F 2230/0004 : Rounded shapes, e.g. with r...A61F 2230/0015 : Kidney-shaped, e.g. bean-sh...A61F 2230/0023 : triangularA61F 2230/0045 : Omega-shapedA61F 2230/0071 : sphericalA61F 2230/0091 : helically-coiled or spirall...A61F 2250/0018 : differing in elasticity, st...A61F 2250/0028 : differing in fibre orientat...A61F 2250/0063 : Nested prosthetic partsA61F 2310/00017 : Iron- or Fe-based alloys, e...