Transpedicular intervertebral disk access methods and devices

• US 20040092988A1
• Filed: 06/25/2003
• Published: 05/13/2004
• Est. Priority Date: 11/08/2002
• Status: Active Grant

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Shaolian, Samuel M., Nguyen, Thanh Van, Pham, To V., Henson, Michael R., Teitelbaum, George P.
• Granted Patent: US 7,867,233 B2
• Time in Patent Office: Days
• US Class Current: 606/167
• CPC Class Codes: A61B 17/1617 with mobile or detachable parts
• CPC Class Codes: A61B 17/1642 for producing a curved bore
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/7097 Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants disc prostheses made of inflatable chambers or pockets filled with fluid A61F2/441; replacing the nucleus pulposus A61F2002/444
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/564 Methods for bone or joint treatment
• CPC Class Codes: A61F 2/442 Intervertebral or spinal discs, e.g. resilient non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455
• CPC Class Codes: A61F 2002/444 for replacing the nucleus pulposus

Abstract

Methods and devices for treating diseases and conditions that change the spacial relationship between the vertebral bodies and the intervertebral disks, or that cause instability of the vertebral column, or both, and a method and devices that allow the surgeon to access the intervertebral space to restore a more normal three-dimensional configuration of the space, with or without additionally fusing two adjacent vertebrae.

Claims

1. An enucleation device comprising:

a) a proximal end;

b) a distal end comprising a cutting cap comprising a plurality of deformable blades; and

c) a shaft between the proximal end and the cutting cap;

where the plurality of deformable blades can cut material in a space when the blades not deformed, after accessing the space through a passage while the blades are deformed; and

where the passage has a smaller cross-sectional area than the lateral cross-sectional area of the undeformed blades while the blades are cutting the material.

2. The enucleation device of claim 1, where the shaft is flexible.

3. The enucleation device of claim 1, further comprising an axial guidewire lumen between the proximal end and the distal end.

4. A method of cutting material in a space, comprising

a) providing the enucleation device of claim 1;

b) accessing the space with the enucleation device; and

c) actuating the device, thereby effecting cutting of the material.

5. The method of claim 4, further comprising:

deforming the blades before actuating the device, and accessing the space through a passage while the blades are deformed;

where the passage has a smaller cross-sectional area than the lateral cross-sectional area of the undeformed blades while the blades are cutting the material.

6. The method of claim 4, where the passage is curved.

7. The method of claim 4, further comprising advancing and retracting the cutting device in the space to cut additional material.

8. The method of claim 4, where accessing the space comprises advancing the cutting device over a guide wire.

9. The method of claim 4, where the material cut is selected from the group consisting of intervertebral disk and vertebral body endplate material.

10. The method of claim 4, where accessing the space comprising advancing the enucleation device through a transpedicular access passage in a vertebra.

11. A method of cutting material in a space, comprising:

a) providing the enucleation device of claim 1;

b) creating a passage to access the space;

c) deforming the blades to fit through the passage;

d) advancing the enucleation device through the passage until the cutting cap passes into the space, thereby allowing the blades to expand to their undeformed shape; and

e) actuating the enucleation device, thereby effecting cutting of the material;

where the passage has a smaller cross-sectional area than the lateral cross-sectional area of the undeformed blades while the blades are cutting the material.

12. The method of claim 11, further comprising advancing and retracting the cutting device in the space to cut additional material.

13. The method of claim 11, where advancing the cutting device through the passage comprises advancing the cutting device over a guide wire.

14. The method of claim 11, where the passage is curved.

15. The method of claim 11, where the material cut is intervertebral disk.

16. The method of claim 11, where the material cut is vertebral body endplate material.

17. The method of claim 11, where the passage is a transpedicular access passage in a vertebra.