Dilation introducer for orthopedic surgery

• US 20050256525A1
• Filed: 01/19/2005
• Published: 11/17/2005
• Est. Priority Date: 11/14/2002
• Status: Abandoned Application

• Current Assignee: Interventional Spine, Inc (Johnson & Johnson)
• Original Assignee: Interventional Spine, Inc (Johnson & Johnson)
• Inventors: Olmos, Fausto, Warren, Christopher, Culbert, Brad
• Application Number:
  US11/038,784
• Publication Number:
  US 20050256525A1
• Time in Patent Office: Days
• US Class Current: 606/53
• CPC Class Codes: A61K 31/713 Double-stranded nucleic acids or oligonucleotides
• CPC Class Codes: A61P 13/12 of the kidneys
• CPC Class Codes: A61P 21/00 Drugs for disorders of the muscular or neuromuscular system
• CPC Class Codes: A61P 25/28 for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
• CPC Class Codes: A61P 3/10 for hyperglycaemia, e.g. antidiabetics
• CPC Class Codes: A61P 35/00 Antineoplastic agents
• CPC Class Codes: A61P 35/02 specific for leukemia
• CPC Class Codes: A61P 37/02 Immunomodulators
• CPC Class Codes: C12N 15/1048 SELEX
• CPC Class Codes: C12N 15/111 General methods applicable to biologically active non-coding nucleic acids
• CPC Class Codes: C12N 15/113 Non-coding nucleic acids modulating the expression of genes, e.g. antisense oligonucleotides; Antisense DNA or RNA; Triplex- forming oligonucleotides; Catalytic nucleic acids, e.g. ribozymes; Nucleic acids used in co-suppression or gene silencing when used in plants C12N15/8218
• CPC Class Codes: C12N 15/1135 against oncogenes or tumor suppressor genes
• CPC Class Codes: C12N 15/1136 against growth factors, growth regulators, cytokines, lymphokines or hormones
• CPC Class Codes: C12N 15/1137 against enzymes viral enzymes C12N15/1131; receptors C12N15/1138
• CPC Class Codes: C12N 15/1138 against receptors or cell surface proteins
• CPC Class Codes: C12N 2310/14 interfering N.A.
• CPC Class Codes: C12N 2320/10 in screening processes
• CPC Class Codes: C12N 2320/11 for the determination of target sites, i.e. of active nucleic acids
• CPC Class Codes: C12Y 113/12007 Photinus-luciferin 4-monooxygenase (ATP-hydrolysing) (1.13.12.7), i.e. firefly-luciferase
• CPC Class Codes: C12Y 502/01008 Peptidylprolyl isomerase (5.2.1.8), i.e. cyclophilin
• CPC Class Codes: G16B 20/00 : ICT specially adapted for functional genomics or proteomics, e.g. genotype-phenotype associations
• CPC Class Codes: G16B 20/20 : Allele or variant detection, e.g. single nucleotide polymorphism [SNP] detection
• CPC Class Codes: G16B 20/50 : Mutagenesis

Abstract

The dilation introducer has a locked assembled configuration for placement of the dilation introducer against a patient'"'"'s tissue to be treated, and an unlocked, collapsed configuration for dilating the patient'"'"'s soft tissue down to tissue to be treated. Dilator tubes are successively released and advanced to progressively expand the patient'"'"'s soft tissue down to the bone tissue to be treated. The dilator tubes and a guide insert may include spikes for engaging bone tissue. The dilation introducer may include a light emitter disposed in a dilator tube. A telescoping expander sleeve is also provided.

Claims

1. In a dilation introducer for surgery on an internal body structure, the dilation introducer having a locked assembled configuration for initial placement of the dilation introducer against a patient'"'"'s bone tissue to be treated, and an unlocked, collapsed configuration dilating the patient'"'"'s soft tissue down to the tissue to be treated to a desired degree of dilation to permit minimally invasive surgical procedures on the patient'"'"'s tissue to be treated, the improvement in the dilation introducer comprising:

at least one dilator tube having a distal end and a proximal end, the distal end of the at least one dilator tube including a plurality of spikes.

2. The dilation introducer of claim 1, wherein said spikes are formed of radiopaque material.

3. The dilation introducer of claim 1, wherein said spikes are formed are formed with a rounded shape so as to deflect soft tissue.

4. The dilation introducer of claim 1, further comprising a parallel guide insert adapted to be received in said at least one additional dilator tube, said parallel guide insert including a main cylindrical shaft having a proximal end connected to a cylindrical head, and a plurality of longitudinal bores extending the length of the parallel guide insert through the main cylindrical shaft and cylindrical head, and wherein parallel guide insert has a distal tip with a plurality of spikes.

5. The dilation introducer of claim 4, wherein said spikes are formed of radiopaque material.

6. The dilation introducer of claim 4, wherein said spikes are formed are formed with a rounded shape so as to deflect soft tissue.

7. A dilation introducer for surgery on an internal structure to be treated, the dilation introducer having a locked assembled configuration for initial placement of the dilation introducer against a patient'"'"'s tissue to be treated, and an unlocked, collapsed configuration dilating the patient'"'"'s soft tissue down to the tissue to be treated to a desired degree of dilation to permit minimally invasive surgical procedures on the patient'"'"'s tissue to be treated, comprising:

a first dilator tube having a distal end with a tapered tip and a proximal end with a cylindrical head;

a second dilator tube, the first dilator tube being removably received in the second dilator tube for slidable telescoping movement within the second dilator tube, the second dilator tube having a distal end with a tapered tip and a proximal end with a cylindrical head, and an inner lumen with a distal opening and a proximal opening; and

means for removably connecting the first and second dilator tubes together in a locked configuration including a first latching member disposed in the cylindrical head of the first dilator tube, the first latching member having locking button connected transversely to a shaft with a latching end projecting from the cylindrical head of the first dilator tube toward the distal end of the first dilator tube, the locking button extending transversely from the shaft through a side aperture in the cylindrical head of the first dilator tube, the locking button being biased outwardly from the cylindrical head, the first latching member being received in an upper aperture of the cylindrical head of the second dilator tube, the upper aperture of the cylindrical head of the second dilator tube having a latching chamber for retaining the latching end of the latching member when the locking button is biased outwardly, to lock the cylindrical heads of the first and second dilator tubes together, the locking button being moveable inwardly to move the latching member inwardly and the latching end of the latching member inwardly out of the latching chamber.

8. The dilation introducer of claim 7, further comprising at least one additional dilator tube, the second dilator tube being removably received in the at least one additional dilator tube for slidable telescoping movement within the at least one additional dilator tube, the at least one additional dilator tube having a distal end and a proximal end with a cylindrical head, an inner lumen with a distal opening and a proximal opening, the distal end having a tapered tip, the second dilator tube and the at least one additional dilator tube having an unlocked configuration in which the at least one additional dilator tube is permitted to slidably telescope over the second dilator tube to dilate the patient'"'"'s soft tissue at the distal end of the dilation introducer;

and

means for removably connecting the second dilator tube and the at least one additional dilator tube together in a locked configuration including a second latching member disposed in the cylindrical head of the second dilator tube, the second latching member having locking button connected transversely to a shaft with a latching end projecting from the cylindrical head of the second dilator tube toward the distal end of the second dilator tube, the locking button extending transversely from the shaft through a side aperture in the cylindrical head of the second dilator tube, the locking button being biased outwardly from the cylindrical head, the second latching member being received in an upper aperture of the cylindrical head of the at least one additional dilator tube, the upper aperture of the cylindrical head of the at least one additional dilator tube having a latching chamber for retaining the latching end of the second latching member when the locking button is biased outwardly, to lock the cylindrical heads of the second and at least one additional dilator tubes together, the locking button being moveable inwardly to move the second latching member inwardly and the latching end of the second latching member inwardly out of the latching chamber.

9. The dilation introducer of claim 8, wherein said at least one additional dilator tube comprises a handle connected to the proximal end of said at least one additional dilator tube, and the cylindrical head of said at least one additional dilator tube including a plurality of said upper apertures each including one said latching chamber for receiving the second latching member.

10. In a dilation introducer for orthopedic surgery, the dilation introducer having a locked assembled configuration for initial placement of the dilation introducer against a patient'"'"'s tissue to be treated, and an unlocked, collapsed configuration dilating the patient'"'"'s soft tissue down to the tissue to be treated to a desired degree of dilation to permit minimally invasive surgical procedures on the patient'"'"'s tissue to be treated, the improvement in the dilation introducer comprising:

at least one dilator tube having a tubular shaft, a distal end and a proximal end, an inner lumen with a distal opening and a proximal opening; and

a light emitter disposed in said at least one additional dilator tube.

11. The dilation introducer of claim 10, wherein said light emitter comprises a light emitting diode.

12. The dilation introducer of claim 11, wherein said light emitting diode is embedded in said tubular shaft of said at least one dilator tube.

13. The dilation introducer of claim 10, wherein said light emitter comprises a fiber optic.

14. The dilation introducer of claim 13, wherein said fiber optic is embedded in said tubular shaft of said at least one dilator tube.

15. The dilation introducer of claim 10, wherein said at least one dilator tube comprises a handle and a switch for controlling said light emitter, and at least one battery is disposed in said handle, said at least one battery being connected to said switch to power said light emitter.

16. The dilation introducer of claim 13, wherein said light emitter further comprises a light source providing light conducted to said at least one fiber optic.

17. The dilation introducer of claim 10, wherein said light emitter comprises at least one elongated energy conducting member disposed on an outer surface of the tubular shaft of said at least one dilator tube.

18. The dilation introducer of claim 17, wherein said at least one elongated energy conducting member is disposed in a groove on the exterior surface of the tubular shaft.

19. A telescoping expander sleeve adapted to be slidably disposed over a shaft of a dilator tube for dilating a patient'"'"'s soft tissue down to tissue to be treated to a desired degree of dilation to permit minimally invasive surgical procedures on the patient'"'"'s tissue to be treated, the telescoping expander sleeve being moveable between an extended, unexpanded configuration and a collapsed, expanded configuration, the telescoping expander sleeve comprising:

a first generally tubular section having a tubular proximal portion and a distal portion, the tubular proximal portion having an enlarged proximal head, and the distal portion including at least two active spreader arms each having a proximal end and a distal tip, said at least two active spreader arms being connected at the proximal end, respectively, to the tubular proximal portion, said distal tips of said at least two active spreader arms being moveable radially between an unexpanded configuration and an expanded configuration;

a second generally tubular section slidably disposed over the first generally tubular section, said second generally tubular section including a tubular proximal portion and a distal portion including at least two passive spreader flaps each having a narrow proximal end and a wide distal tip, said proximal ends of said at least two passive spreader flaps being hingedly connected to said tubular proximal portion, said distal tips of said at least two passive spreader flaps being moveable radially between an unexpanded configuration and an expanded configuration, said at least two active spreader arms slidably engaging said at least two passive spreader flaps, so that as the telescoping expander sleeve telescopes from the extended, unexpanded configuration to a collapsed, expanded configuration, said at least two active spreader arms slide from the narrow proximal ends of said at least two passive spreader flaps to the wider distal ends of the passive spreader flaps to spread the distal ends of said at least two passive spreader flaps apart and to spread the distal ends of said at least two active spreader arms apart.

20. The telescoping expander sleeve of claim 19, wherein the distal tips of said at least two active spreader arms have beveled edges to deflect soft tissue during insertion of the telescoping expander sleeve.

21. The telescoping expander sleeve of claim 19, wherein the distal tips of said at least two passive spreader flaps have beveled edges to deflect soft tissue during insertion of the telescoping expander sleeve.

22. A guide wire assembly for use with a telescoping dilation introducer in treatment of soft tissue, to provide a surface against which the telescoping dilation introducer can be pushed during operation of the telescoping dilation introducer, comprising:

an elongated tubular section having a proximal end, a distal end, an internal bore, and a frustoconical distal tip with a narrowed portion at the distal end and an enlarged flat shoulder at a proximal portion of the frustoconical distal tip; and

an elongated generally cylindrical section removably received in said internal bore of said elongated tubular section, the elongated generally cylindrical section having a proximal enlarged head and an elongated body portion, said elongated body portion having a proximal end and a distal end, said distal end having a pointed distal tip, such that when said elongated generally cylindrical section is received in said elongated tubular section, said pointed distal tip extends out of the distal end of said frustoconical distal tip to present a sharp point that can be positioned in soft tissue, and such that when said elongated generally cylindrical section is thereafter removed, said enlarged flat shoulder of said frustoconical distal tip provides a surface against which a telescoping dilation introducer can be pushed for operation of the telescoping dilation introducer in treatment of soft tissue.

23. The guide wire assembly of claim 22, wherein said elongated body portion of said elongated generally cylindrical section includes a proximal section adjacent to said proximal enlarged head and an elongated main section connected to the proximal section, said proximal section having a diameter larger than an outer diameter of said elongated tubular section, and said elongated main section having a diameter narrower than the diameter of said internal bore of said elongated tubular section so as to be receivable in said internal bore of said elongated tubular section, such that when said elongated main section is received in said internal bore of said elongated tubular section and said proximal section of the elongated body portion of the elongated generally cylindrical section is seated against said proximal end of said elongated tubular section, said pointed distal tip extends out of said frustoconical distal tip of said elongated tubular section so that said guide wire assembly presents a pointed distal end.