Tools for Percutaneous Spinal Ligament Decompression and Device for Supporting Same

• US 20070055263A1
• Filed: 07/31/2006
• Published: 03/08/2007
• Est. Priority Date: 07/29/2005
• Status: Abandoned Application

• Current Assignee: Vertos Medical, Inc.
• Original Assignee: X-Sten Incorporated
• Inventors: Schomer, Donald, Way, Bryce, Solsberg, Murray
• Application Number:
  US11/461,020
• Publication Number:
  US 20070055263A1
• Time in Patent Office: Days
• US Class Current: 606/82
• CPC Class Codes: A61B 10/025 for taking bone, bone marrow or cartilage samples
• CPC Class Codes: A61B 10/0275 with sample notch, e.g. on the side of inner stylet
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 17/32075 Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
• CPC Class Codes: A61B 2017/32004 having a laterally movable cutting member at its most distal end which remains within the contours of said end
• CPC Class Codes: A61B 2017/320064 with tissue or sample retaining means

Abstract

A device for providing percutaneous access to a surgical site. In an embodiment, the device comprises a handle. In addition, the device comprises a bone-cutting member extending from the handle, wherein the bone-cutting member includes a handle end fixed to the handle and a cutting end. Further, the device comprises a portal including a first end, a second end, and a through bore extending therebetween, wherein the bone-cutting member is disposed within the through bore and concentric with the portal Still further, the portal has a first position with the second end releasably coupled to the handle and a second position with the second end released from the handle and the bone-cutting member.

Claims

1. A device for providing percutaneous access to a surgical site, comprising:

a handle;

a bone-cutting member extending from said handle, wherein said bone-cutting member includes a handle end fixed to said handle and a cutting end;

a portal including a first end, a second end, and a through bore extending therebetween, wherein said bone-cutting member is disposed within said through bore;

wherein said portal has a first position in which said second end is releasably coupled to said handle and a second position in which said second end is released from said handle and said bone-cutting member.

2. The device according to claim 1 wherein said portal threadingly engages said handle.

3. The device according to claim 1 wherein said bone-cutting member comprises a cannulated bone saw.

4. The device according to claim 1 wherein said first end of said portal includes a beveled edge.

5. The device according to claim 1 wherein said second end of said portal includes a portal cup adapted to releasably engage said handle.

6. The device of claim 1 wherein said portal has an outer surface and wherein at least a portion of said outer surface includes a textured surface feature proximal said first end.

7. The device of claim 6 wherein said textured surface feature is spaced at least 1/16^th of an inch from said first end.

8. The device of claim 7 wherein said textured surface feature is spaced at least ⅛

^th of an inch from said first end.

9. The device of claim 6 wherein said textured surface feature is adapted to hold and apply bone wax to a bone.

10. The device of claim 6 wherein said textured surface feature comprises diamond knurling, sand blasting, bead blasting, media blasting, vertical grooves, horizontal grooves or plasma etching.

11. The device of claim 1 wherein said portal has a length measured from said first end to said second end, wherein said length of said portal is between 2 and 6 inches.

12. The device of claim 1 further comprising a repositioning device including a rigid elongate rod having an outside diameter that is less than the inside diameter of said through bore of said portal.

13. The device of claim 1 wherein said portal comprises 400 series stainless steel, 17 series stainless steel, or 300 series stainless steel.

18. The device according to claim 9 wherein said portal and said bone-cutting member are formed as a single integral component.

14. A system for performing a percutaneous ligamentum flavum decompression comprising:

a handle;

a bone-cutting member extending from said handle;

a portal comprising a cannulated member extending from said handle and concentric with said bone-cutting member, wherein said portal is releasably coupled to said handle;

a tissue-excision device sized and configured to pass through said portal.

15. The system of claim 14 wherein said portal includes a first end, a second end, and a through bore extending therebetween, wherein said bone-cutting member is disposed within said through bore.

16. The system of claim 15 wherein said portal has a first position with said second end releasably coupled to said handle and a second position with said second end released from said handle and said bone-cutting member.

17. The system of claim 14 wherein said bone-cutting member comprises a cannulated bone saw.

19. The device according to claim 14 wherein said second end of said portal threadingly engages said handle.

20. A method for treating stenosis in a spine, the spine including a thecal sac, a spinal canal and an epidural space therebetween, the stenosis determining a region of interest in the spine, comprising the steps of:

a) compressing the thecal sac in the region of interest by injecting a fluid to form a safety zone and establish a working zone, the safety zone lying between the working zone and the thecal sac;

b) percutaneously cutting a hole through a lamina of the spine adjacent the region of interest;

c) positioning a portal through said hole to provide access to the region of interest;

d) inserting a tissue-excision tool through the portal and into tissue in the working zone;

e) using the tool to percutaneously reduce the stenosis; and

f) utilizing imaging to visualize the position of the tool during at least a part of step e).

21. The method of claim 21 further comprising the step of applying bone wax to said hole cut through the lamina to reduce bone bleeding.