APPARATUS FOR PERFORMING A DISCECTOMY THROUGH A TRANS-SACRAL AXIAL BORE WITHIN THE VERTEBRAE OF THE SPINE

• US 20060264957A1
• Filed: 07/28/2006
• Published: 11/23/2006
• Est. Priority Date: 02/16/2000
• Status: Abandoned Application

• Current Assignee: Baxano Surgical, Inc.
• Original Assignee: TranS1 Incorporated (Baxano Surgical, Inc.)
• Inventors: Cragg, Andrew H., Kagan, Jonathan
• Application Number:
  US11/460,892
• Publication Number:
  US 20060264957A1
• Time in Patent Office: Days
• US Class Current: 606/80
• CPC Class Codes: A61B 17/1617 with mobile or detachable parts
• CPC Class Codes: A61B 17/1671 for the spine
• 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 17/3203 Fluid jet cutting instruments
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 17/66 Alignment, compression or distraction mechanisms
• CPC Class Codes: A61B 17/70 Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
• CPC Class Codes: A61B 17/7055 connected to sacrum, pelvis or skull
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/00734 battery operated
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/320733 with a flexible cutting or scraping element, e.g. with a whip-like distal filament member
• CPC Class Codes: A61F 2/441 made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
• 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 2/4455 for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages intervertebral discs A61F2/442
• CPC Class Codes: A61F 2/4465 having a circular or kidney shaped cross-section substantially perpendicular to the axis of the spine
• CPC Class Codes: A61F 2/4601 for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/2821 : Bone stimulation by electromagnetic fields or electric current for enhancing ossification
• CPC Class Codes: A61F 2002/2835 : Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
• CPC Class Codes: A61F 2002/30092 : using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2002/30291 : spirally-coiled, i.e. having a 2D spiral cross-section
• CPC Class Codes: A61F 2002/3055 : for adjusting length
• CPC Class Codes: A61F 2002/30563 : having elastic means or damping means, different from springs, e.g. including an elastomeric core or shock absorbers
• CPC Class Codes: A61F 2002/30566 : Helical springs
• CPC Class Codes: A61F 2002/30593 : hollow
• CPC Class Codes: A61F 2002/30677 : Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body
• CPC Class Codes: A61F 2002/30774 : internally-threaded
• CPC Class Codes: A61F 2002/30841 : Sharp anchoring protrusions for impaction into the bone, e.g. sharp pins, spikes
• CPC Class Codes: A61F 2002/3085 : with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
• CPC Class Codes: A61F 2002/30879 : Ribs
• CPC Class Codes: A61F 2002/30884 : Fins or wings, e.g. longitudinal wings for preventing rotation within the bone cavity
• CPC Class Codes: A61F 2002/30892 : parallel
• CPC Class Codes: A61F 2002/30925 : etched
• CPC Class Codes: A61F 2002/3097 : using laser
• CPC Class Codes: A61F 2002/448 : comprising multiple adjacent spinal implants within the same intervertebral space or within the same vertebra, e.g. comprising two adjacent spinal implants
• CPC Class Codes: A61F 2002/4631 : the prosthesis being specially adapted for being cemented
• CPC Class Codes: A61F 2210/0014 : using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2230/0091 : helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section
• CPC Class Codes: A61F 2310/00353 : Bone cement, e.g. polymethylmethacrylate or PMMA
• CPC Class Codes: A61N 5/1027 : Interstitial radiation therapy

Abstract

Methods and apparatus for and performing a partial or complete discectomy of an intervertebral spinal disc accessed by one or more trans-sacral axial spinal instrumentation/fusion (TASIF) axial bore formed through vertebral bodies in general alignment with a visualized, trans-sacral anterior or posterior axial instrumentation/fusion line (AAIFL or PAIFL) line. A discectomy instrument is introduced through the axial bore, the axial disc opening, and into the nucleus to locate a discectomy instrument cutting head at the distal end of the discectomy instrument shaft within the nucleus. The cutting head is operated by operating means coupled to the instrument body proximal end for extending the cutting head laterally away from the disc opening within the nucleus of the intervertebral spinal disc and for operating the cutting head to form a disc cavity within the annulus extending laterally and away from the disc opening or a disc space wherein the disc cavity extends through at least a portion of the annulus. A discectomy sheath that is first introduced to extend from the skin incision through the axial bore and into the axial disc opening having a discectomy sheath lumen that the discectomy instrument is introduced through. The discectomy sheath is preferably employed for irrigation and aspiration of the disc cavity or just aspiration if irrigation fluids are introduced through a discectomy instrument shaft lumen. The cutting head of the discectomy tool is deflected from the sheath lumen laterally and radially toward the annulus using a deflecting catheter or pull wire.

Claims

1. An assembly for cutting material inside an intervertebral spinal disc, the intervertebral spinal disc having a disc body formed of a nucleus and annulus, through a trans-sacral axial bore extending cephalad and axially from a sacral position of a sacral vertebral body through one or more vertebral body and through a vertebral body endplate and axial disc opening into the nucleus of the intervertebral spinal disc, the assembly comprising:

an elongated discectomy instrument having a discectomy instrument body extending between a discectomy instrument proximal end and instrument distal end, a cutting head located in a distal portion of the discectomy instrument, the instrument body and cutting head dimensioned to fit within and to extend through the axial bore;

a sheath, coaxially carried by the discectomy instrument and within which the discectomy instrument is axially moveable, the cutting head movable between a laterally extending orientation when unconstrained by the sheath, and an axial orientation when constrained by the sheath; and

an anterior tract sheath having a distal end for engaging an anterior surface of the sacral vertebral body.

2. The apparatus of claim 1, further comprising aspiration means for aspirating a disc cavity or disc space within the intervertebral spinal disc.

3. The apparatus of claim 1, wherein the cutting head comprises a fragmenting element for fragmenting the nucleus or annulus into fragments to form a disc cavity or disc space within the intervertebral spinal disc.

4. The apparatus of claim 3, further comprising aspiration means for aspirating nucleus or annulus fragments from the disc cavity or disc space.

5. The apparatus of claim 3, further comprising:

irrigation means for delivering irrigation fluid into the disc cavity or disc space; and

aspiration means for aspirating the nucleus fragments and irrigation fluid from the disc cavity or disc space.

6. The apparatus of claim 1, further comprising:

means for accessing the sacral position of the sacral vertebral body; and

means operable from the accessed sacral position for boring a trans-sacral axial bore cephalad and axially through a series of adjacent vertebral bodies and any intervening spinal discs.

7. The apparatus of claim 1, further comprising:

means for accessing the anterior surface of the sacral vertebral body; and

means operable from the accessed anterior surface for boring a trans-sacral axial bore cephalad and axially through a series of adjacent vertebral bodies and any intervening spinal discs.