Methods and apparatuses for fixation of the spine through an access device

• US 20050090833A1
• Filed: 10/24/2003
• Published: 04/28/2005
• Est. Priority Date: 10/24/2003
• Status: Active Grant

• Current Assignee: Zimmer Biomet Spine, Inc. (Zimvie Incorporated)
• Original Assignee: Zimmer Spine, Inc. (Zimmer Biomet Holdings, Inc.)
• Inventors: DiPoto, Gene
• Granted Patent: US 7,731,737 B2
• Time in Patent Office: Days
• US Class Current: 606/99
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3439 with means for changing the inner diameter of the cannula, e.g. expandable A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 17/7032 Screws or hooks with U-shaped head or back through which longitudinal rods pass
• CPC Class Codes: A61B 17/7037 wherein pivoting is blocked when the rod is clamped
• CPC Class Codes: A61B 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/7079 Tools requiring anchors to be already mounted on an implanted longitudinal or transverse element, e.g. where said element guides the anchor motion
• CPC Class Codes: A61B 17/7082 for driving, i.e. rotating, screws or screw parts specially adapted for spinal fixation, e.g. for driving polyaxial or tulip-headed screws driving other bone screws A61B17/8875
• CPC Class Codes: A61B 17/7083 Tools for guidance or insertion of tethers, rod-to-anchor connectors, rod-to-rod connectors, or longitudinal elements
• CPC Class Codes: A61B 17/7091 for applying, tightening or removing longitudinal element-to-bone anchor locking elements, e.g. caps, set screws, nuts or wedges
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/320032 Details of the rotating or oscillating shaft, e.g. using a flexible shaft
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms

Abstract

In a method of treating the spine of a patient, an access device is inserted into the patient with the access device in a first configuration having a first cross-sectional area at a distal portion thereof. The access device is actuated to a second configuration having an enlarged cross-sectional area at the distal portion thereof such that the distal portion extends across at least a portion of each of two adjacent vertebrae. A stabilization of the vertebrae is then achieved using either translaminar facet screw fixation or transfacet pedicle screw fixation.

Claims

1. A method of fixing adjoining vertebrae of the spine of a patient, comprising:

inserting into said patient an access device to a surgical location adjacent the spine with said access device in a first configuration having a first cross-sectional area at a distal portion thereof;

actuating said access device to a second configuration having an enlarged cross-sectional area at said distal portion thereof;

delivering a first fastener through the access device to the surgical location; and

advancing said first fastener through a first vertebra and into a second vertebra.

2. The method of claim 1, wherein the access device is inserted via a generally posterior approach.

3. The method of claim 1, wherein the access device is inserted via a posterolateral approach.

4. The method of claim 1, further comprising the introduction of a boring tool to the surgical location through the access device and advancing said boring tool to create a tunnel through the bone prior to delivering said first fastener.

5. The method of claim 1, wherein the surgical location is scored prior delivering the fastener or boring through the bone.

6. The method of claim 1, wherein the method of fixation is transfacet pedicle screw fixation.

7. The method of claim 1, wherein the method of fixation is translaminar facet screw fixation.

8. The method of claim 1, further comprising delivering through an access device a second fastener to a second surgical location at the spine and advancing the fastener through the first vertebra and into the second vertebra, said fastener substantially preventing movement of the first vertebra relative to the second vertebra.

9. The method of claim 8, further comprising prior to delivering said second fastener, introducing a boring tool to said second surgical location through the access device and advancing said boring tool to create a tunnel through the bone.

10. The method of claim 8, wherein said second fastener is delivered through the same access device used to deliver said first fastener.

11. The method of claim 8, wherein said second fastener is delivered through a second access device.

12. The method of claim 8, wherein said second fastener is delivered through a cannula.

13. The method of claim 8, wherein said second surgical location is scored prior delivering said second fastener or boring through the bone

14. A method of treating a spine of a patient, comprising:

inserting an access device into said patient to a surgical location adjacent the spine with said access device in a first configuration having a first cross-sectional area at a distal portion thereof;

actuating said access device to a second configuration having an enlarged cross-sectional area at said distal portion thereof; and

fastening through a first vertebra and into a second vertebra one or more fasteners delivered through said access device, said one or more fasteners providing a transfacet fixation method substantially preventing movement of the first vertebra relative to the second vertebra.

15. The method of claim 14, wherein the access device is inserted via a generally posterior approach.

16. The method of claim 14, wherein the access device is inserted via a posterolateral approach.

17. The method of claim 14, wherein a single access device is used to approach the surgical location adjacent the spine.

18. The method of claim 14, wherein multiple access devices are used to approach the surgical location adjacent the spine.