ACCESS DEVICE FOR MINIMALLY INVASIVE SURGERY

• US 20090143829A1
• Filed: 02/11/2009
• Published: 06/04/2009
• Est. Priority Date: 05/16/2003
• Status: Active Grant

• Current Assignee: Zimmer Biomet Spine, Inc. (Zimvie Incorporated)
• Original Assignee: Zimmer Spine, Inc. (Zimmer Biomet Holdings, Inc.)
• Inventors: Shluzas, Alan E.
• Granted Patent: US 8,608,651 B2
• Time in Patent Office: Days
• US Class Current: 606/86.A
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/025 Joint distractors
• 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 17/7032 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 17/7082 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 2017/0256 for the spine
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 2090/3614 using optical fibre
• CPC Class Codes: A61F 2/28 Bones joints A61F2/30
• 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 2/4611 of spinal prostheses
• 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 2002/30133 kidney-shaped or bean-shaped
• CPC Class Codes: A61F 2002/30879 Ribs
• CPC Class Codes: A61F 2002/30892 parallel
• 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 2230/0015 Kidney-shaped, e.g. bean-shaped
• CPC Class Codes: A61F 2310/00017 : Iron- or Fe-based alloys, e.g. stainless steel
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys
• CPC Class Codes: A61F 2310/00359 : Bone or bony tissue

Abstract

A retractor has a proximal portion comprising a first side portion having a first longitudinal edge and a second side portion having a second longitudinal edge. The first and second portions being movable relative to each other such that the first and second longitudinal edges can be positioned in close proximity to each or spaced apart by a selected distance. A distal portion has an outer surface and an inner surface partially defining a passage. The distal portion is capable of having a configuration when inserted within the patient wherein the cross-sectional area of the passage at a first location is greater than the cross-sectional area of the passage at a second location, wherein the first location is distal to the second location.

Claims

1. A method of stabilizing one or more vertebral levels of a spine, the method comprising:

forming a posterior incision lateral to a spinous process of the spine;

inserting an access device into the incision, the access device having an open inner area sized and shaped to provide simultaneous access to a pedicle of a first vertebra and a pedicle of an adjacent second vertebra, and having a long axis aligned with an axis extending between the pedicles; and

implanting a dynamic spinal stabilization device onto the pedicles through the open inner area of the access device.

2. The method of claim 1, wherein the access device has an oval cross-sectional shape.

3. The method of claim 1, wherein the open inner area of the access device is sized and shaped to provide simultaneous access to the pedicle of the first vertebra, the pedicle of the second vertebra, and a pedicle of a third vertebra.

4. The method of claim 1, wherein the access device has a first configuration and a second configuration, wherein the access device is inserted into the incision in the first configuration and then expanded to the second configuration to provide access to the pedicles of the first and second vertebrae.

5. The method of claim 1, wherein the dynamic spinal stabilization device is implanted onto each of the pedicles without repositioning the access device.

6. The method of claim 1, further comprising repeating the method on a contra-lateral side of the spinous process of the spine.

7. The method of claim 1, wherein forming a posterior incision further comprises manually displacing muscle tissue overlaying the spinous process of the spine.

8. The method of claim 1, further comprising stretching a length and width of the incision prior to inserting the access device into the incision.

9. The method of claim 1, wherein implanting a dynamic spinal stabilization device onto the pedicles includes attaching a first fastener to the pedicle of the first vertebra through the access device and attaching a second fastener to the pedicle of the second vertebra through the access device.

10. The method of claim 9, wherein the access device is not repositioned between attaching the first fastener and attaching the second fastener.

11. The method of claim 9, further comprising attaching an elongate member between the first fastener and the second fastener.

12. The method of claim 11, wherein each of the first fastener and the second fastener includes a screw portion and a housing, wherein the elongate member is secured to the housing of each of the first fastener and the second fastener.

13. The method of claim 1, wherein implanting a dynamic spinal stabilization device includes viewing the position of the dynamic spinal stabilization device relative to the pedicles through the access device.