Non cannulated dilators

• US 20050004593A1
• Filed: 07/26/2004
• Published: 01/06/2005
• Est. Priority Date: 10/30/2001
• Status: Abandoned Application

• Current Assignee: DePuy Synthes Products LLC (Johnson & Johnson)
• Original Assignee: Depuy Spine Incorporated (Johnson & Johnson)
• Inventors: Simonson, Robert E.
• Application Number:
  US10/899,707
• Publication Number:
  US 20050004593A1
• Time in Patent Office: Days
• US Class Current: 606/191
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2090/062 penetration depth
• CPC Class Codes: A61M 29/00 Dilators with or without means for introducing media, e.g. remedies instruments for performing visual medical inspections of cavities or tubes of the body A61B1/00

Abstract

A non-cannulated dilator that is designed with a rigid elongated solid body and with a judiciously configured tip is utilized as the first dilator of a series of dilators which are inserted into the body of a patient for minimally invasive spinal surgery and is made from a solid elongated body, that could be round, ovoid or other cross sectional configuration whose diameter is greater than one and a half (1½) millimeter, and that includes a tool engaging end portion at the proximal end is sufficiently rigid so as not to bend and has a pointed shaped insertion end portion at the distal end with the point of the pointed end being discreetly blunted and utilized in a surgical procedure as a replacement of the typical guide wire and is characterized as providing a “fee” to the surgeon as it penetrates through the tissue and muscle of the patient as it proceeds toward the target.

Claims

1. A method of creating a working channel from a skin incision to proximate a vertebra, comprising:

making a skin incision,

inserting a distal end of a non cannulated dilator into the skin incision,

advancing the distal end of the dilator into proximity to a vertebra, the dilator extending from proximate the vertebra to external to the skin. incision,

inserting a cannula over the non cannulated dilator, and

removing the non cannulated dilator, a bore of the cannula defining a working channel from the skin incision to proximate the vertebra.

2. The method of claim 1, wherein the distal end of the non cannulated dilator is advanced into contact with the vertebra.

3. The method of claim 2, wherein a distal end of the cannula is advanced into contact with the vertebra.

4. The method of claim 1, wherein the distal end of the non cannulated dilator is advanced into contact with the inferior edge of the superior lamina of the vertebra.

5. The method of claim 1, further comprising selecting the size of the cannula based on the advancement of the non cannulated dilator into proximity to a vertebra.

6. The method of claim 5, wherein the non cannulated dilator is graduated to facilitate sizing of the cannula.

7. The method of claim 1, further comprising inserting a second cannula over the cannula, and inserting a third cannula over the second cannula.

8. The method of claim 1, wherein the non cannulated dilator has a diameter greater than one and a half millimeters.

9. The method of claim 1, wherein the non cannulated dilator is cylindrical in shape.

10. The method of claim 1, wherein the non cannulated dilator is ovoid in shape.

11. The method of claim 1, wherein the bore of the cannula has a circular cross-section.

12. The method of claim 1, wherein the bore of the cannula has an ovoid cross-section.

13. The method of claim 1, further comprising connecting a tool to a proximal end of the non cannulated dilator;

and manipulating the tool to facilitate advancement of the non cannulated dilator into proximity to the vertebra.

14. A kit comprising:

a non cannulated dilator having an elongated solid and generally rigid shaft having a proximal end spaced apart from a distal end, the shaft being sized to extend from a skin incision to proximate a vertebra, the shaft having a shaft diameter greater than one and a half millimeter, and

a plurality of cannulas, each cannula including a bore having a bore diameter and being sized to extend from a skin incision to proximate a vertebra, at least some of the cannulas each having a bore diameter greater than a bore diameter of another cannula.

15. The kit of claim 14, wherein the plurality of cannulas comprises a first cannula having a first bore diameter greater than the shaft diameter,

a second cannula having a second bore diameter greater than the first bore diameter, and

a third cannula having a third bore diameter greater than the second bore diameter.

16. The kit of claim 14, wherein the distal end of the shaft tapers to a blunt tip.

17. The kit of claim 14, wherein the shaft includes indicia indicative of a graduated scale.

18. The kit of claim 14, wherein the shaft on the non cannulated dilator is cylindrical in shape.

19. The kit of claim 14, wherein the shaft of the non cannulated dilator is ovoid in shape.

20. The kit of claim 14, wherein the bore of at least one of the cannulas has circular cross-section.

21. The kit of claim 14, wherein the bore of at least one of the cannulas has an ovoid cross-section.

22. A method of creating a working channel through tissue to proximate a vertebra, comprising:

inserting a blunt tip of a non cannulated dilator through tissue to position the tip of the non cannulated dilator adjacent a target site on a vertebra;

inserting at least one dilator over the non cannulated dilator;

inserting a cannula over the at least one dilator and the non cannulated dilator;

removing the at least one dilator and the non cannulated dilator such that the cannula defines a working channel extending therethrough.

23. The method of claim 22, further comprising, prior to inserting the cannula, measuring a depth from a tissue surface to a target site on a vertebra.

24. The method of claim 23, wherein the cannula has a size that is commensurate with the measured depth.

25. The method of claim 23, wherein the depth of the pathway is measured using indicia formed on at least one of the non cannulated dilator and the at least one dilator.

26. The method of claim 22, wherein a distal end of the cannula is advanced into contact with the vertebra.

27. A method of creating a working channel through tissue to a surgical target, comprising:

inserting a non cannulated dilator through tissue to form a pathway to a surgical target;

inserting a series of cannulated dilators over the non cannulated dilator;

measuring a depth of the pathway;

inserting a cannula having a depth commensurate with the measured depth over the dilators;

removing the dilators such that a working channel extends through the cannula to the surgical target.

28. The method of claim 27, wherein the depth of the pathway is measured using indicia formed on at least one of the non cannulated dilator and the series of cannulated dilators.

29. The method of claim 27, wherein a distal end of the cannula is advanced into contact with the vertebra.