Ultrasonic cutting device

• US 20060195107A1
• Filed: 02/02/2005
• Published: 08/31/2006
• Est. Priority Date: 02/02/2005
• Status: Active Grant

• Current Assignee: DePuy Synthes Products LLC (Johnson & Johnson)
• Original Assignee: DePuy Synthes Products LLC (Johnson & Johnson)
• Inventors: Jones, Bryan S., Ramsay, Christopher
• Granted Patent: US 8,628,534 B2
• Time in Patent Office: Days
• US Class Current: 606/79
• CPC Class Codes: A61B 17/1624 Drive mechanisms therefor
• CPC Class Codes: A61B 17/1644 using fluid other than turbine drive fluid
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/22 Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for dilators A61M29/00
• CPC Class Codes: A61B 17/22004 using mechanical vibrations, e.g. ultrasonic shock waves A61B17/225 takes precedence
• CPC Class Codes: A61B 17/320068 using mechanical vibrations, e.g. ultrasonic A61B17/22012 takes precedence; dental tooth drilling devices operated by vibration A61C3/03; removing intra-ocular material using mechanical vibrations A61F9/00745
• CPC Class Codes: A61B 2017/1651 for cooling

Abstract

An ultrasonic surgical cutting method and apparatus is provided wherein the method and apparatus allows for the cutting of bone from within a hollow pathway such that a cutter associated with the ultrasonic method and apparatus remains sufficiently cool to prevent necrosis of the bone being cut. Furthermore the ultrasonic device and method can be employed in the cutting of soft tissue, wherein a cooled cutter is used to prevent the sticking of soft tissue to the cutting blade of the device during use.

Claims

1. ) A method for cutting the pedicle region of a vertebra during spinal surgery with an ultrasonic cutting tool, comprising:

providing a pathway into the pedicle of vertebrae to be cut;

locating a ultrasonic cutting tool into said pathway at a fixed distance, wherein said tool contains a cutting tip;

extending said cutting tip from within said pathway; and

rotating said cutting tip in a circumferential manner such that the pedicle region of vertebrae is cut by said tip.

2. ) The method of claim 1, wherein said cutting tip is constructed of a bio-compatible material

3. ) The method of claim 1, wherein said ultrasonic cutting tool operates in the frequency range between about 22 Khz and about 45 Khz.

4. ) The method of claim 1, wherein said ultrasonic cutting tool operates in the amplitude range between about 50 to about 100 microns.

5. ) The method of claim 1, further comprising the providing of a guide tube, wherein said guide tube is sized and oriented to fit within the hollow pathway into the vertebrae.

6. ) The method of claim 1, further comprising the providing of a hand piece assembly, wherein said hand piece assembly is used in extending the cutting tip from within the guide tube.

7. ) The method of claim 6, further comprising the rotating of the hand piece assembly such that the ultrasonic cutting tip is rotated in a circumferential manner.

8. ) The method of claim 1, further comprising the locating of the cutting tip on an axis parallel to the longitudinal axis of the guide tube.

9. ) The method of claim 1, further comprising the providing of a convective cooling pathway associated with the ultrasonic cutter, such that heat generated by the ultrasonic cutter is removed using the convective cooling pathway.

10. ) The method of claim 5, further comprising the providing of an adjustable stop, wherein said adjustable stop is associated with the guide tube such that the distance that the guide tube is inserted into the hollow pathway is predefined.

11. ) A method for removing heat from an ultrasonic surgical cutter, comprising:

providing a hollow vibratory shaft associated with an ultrasonic transducer and a cutter, wherein said ultrasonic transducer is associated with a first end of the vibratory shaft and the cutter is associated with a second end of the hollow vibratory shaft;

providing a thermally conductive cellular matrix within a region of the vibratory shaft, said cellular matrix having a hollow central region disposed within the cellular matrix; and

providing a working fluid for use with said cellular matrix, such that a convective thermal gradient is established through the cellular matrix originating at the second end associated with the cutter such that heat is removed from the second end associated with the cutter.

12. ) The method of claim 11, wherein the ultrasonic surgical cutter is used in the cutting of bone.

13. ) The method of claim 11, wherein said cellular matrix is a copper based compound.

14. ) The method of claim 11, wherein said thermally conductive cellular matrix provides for the removal of heat generated at the cutter.

15. A method of performing a surgical procedure comprising:

creating an access passage from a skin incision to proximate a vertebra, introducing an ultrasonic cutting tool through the access passage, and cutting a portion of the vertebra or disk material proximate the vertebra with the ultrasonic cutting tool.

16. The method of 15, further comprising inserting at least one dilator through the skin incision and advancing a distal end of the dilator into proximity to the vertebra to expand the incision and create the access passage.

17. The method of 16, further comprising delivering an access port over the dilator, the access ort defining the access passage to proximate a vertebra.

18. The method of 15, further comprising inserting a retractor through the skin incision, advancing a distal end of the retractor into proximity to the vertebra, and expanding the retractor to create the access portal.

19. A method of performing a surgical procedure comprising, delivering a cutting tip of an ultrasonic cutting tool to proximate a vertebra;

cutting a portion of the vertebra with the cutting tip of the ultrasonic cutting tool; and

cooling the cutting tip to temperature sufficient to inhibit necrosis of tissue proximate the cutting tip.

24. The method of claim 19, wherein the cutting tip is cooled by a convection cooling system coupled to the ultrasonic cutting tool.

20. The method of 19, wherein the cutting tip is cooled to a temperature less than approximately 50°

C.

21. The method of 19, wherein the cutting tip is cooled to a temperature less than approximately 45°

C.

22. The method of 19, wherein the cutting tip is cooled to a temperature less than approximately 40°

C.

23. The method of 19, wherein the cutting tip is cooled to a temperature approximate to body temperature.