SPINAL PLATFORM AND METHOD FOR DELIVERING A THERAPEUTIC AGENT TO A SPINAL CORD TARGET

• US 20100030184A1
• Filed: 04/03/2009
• Published: 02/04/2010
• Est. Priority Date: 04/04/2008
• Status: Active Grant

• Current Assignee: Cleveland Clinic Foundation
• Original Assignee: Cleveland Clinic Foundation
• Inventors: BOULIS, NICHOLAS M., KOTSCHI, HELMUTH, SHAWAN, ANTHONY J.
• Granted Patent: US 8,092,495 B2
• Time in Patent Office: Days
• US Class Current: 604/500
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 17/3472 for bones, e.g. intraosseus injections
• CPC Class Codes: A61B 2017/3407 including a base for support on the body
• CPC Class Codes: A61B 2090/067 for measuring angles
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61B 90/14 Fixators for body parts, e.g. skull clamps; Constructional details of fixators, e.g. pins
• CPC Class Codes: A61B 90/50 Supports for surgical instruments, e.g. articulated arms
• CPC Class Codes: A61M 2210/1003 Spinal column

Abstract

A spinal platform for delivering a therapeutic agent to a spinal cord target includes a brace member for attachment to a plurality of bony structures surrounding at least a portion of the spinal cord target, a carriage member operatively coupled to and movable along the brace member, and a universal joint for adjusting the coronal or sagittal angle of a surgical instrument. The brace member includes at least one longitudinal rail and a plurality of attachment members. The plurality of attachment members is operably connected to the at least one longitudinal rail. The at least one longitudinal rail includes a proximal end portion, a distal end portion, and a middle portion extending between the proximal and distal end portions. The universal joint is seated within a portion of the carriage member and is capable of delivering the therapeutic agent to the spinal cord target.

Claims

1. A spinal platform for delivering a therapeutic agent to a spinal cord target, said spinal platform comprising:

a brace member for attachment to a plurality of bony structures surrounding at least a portion of the spinal cord target, said brace member comprising at least one longitudinal rail and a plurality of attachment members operably attached to said at least one longitudinal rail, said plurality of attachment members for securing said brace member to the plurality of bony structures, said at least one longitudinal rail including a proximal end portion, a distal end portion, and a middle portion extending between said proximal and distal end portions;

a carriage member operatively coupled to and movable along said brace member; and

a universal joint for adjusting the coronal or sagittal angle of a surgical instrument, said universal joint being seated within a portion of said carriage member and being capable of delivering the therapeutic agent to the spinal cord target.

2. The spinal platform of claim 1, wherein said brace member further comprises oppositely disposed first and second longitudinal rails, said plurality of attachment members being operably connected to and extending between said first and second longitudinal rails.

3. The spinal platform of claim 1, wherein said plurality of attachment members further comprises:

a first clamp member operably secured to said proximal end portion of each of said first and second longitudinal rails; and

a second clamp member operably secured to said distal end portion of each of said first and second longitudinal rails.

4. The spinal platform of claim 2, wherein each of said first and second clamp members comprises:

a T-shaped clamp body, said clamp body comprising a receptacle portion and an arm portion extending radially from said receptacle portion, said receptacle portion including first and second openings for receiving said first and second longitudinal rails, respectively, said arm portion including an axially-extending channel;

an L-shaped clamp pin having a first end and a contacting portion, said first end for insertion into said axially-extending channel; and

a clamp fastener for mating with said first end of said clamp pin to secure said clamp pin to said receptacle portion.

5. The spinal platform of claim 2, wherein said plurality of attachment members further comprises:

a first base member operably secured to said proximal end portion of each of said first and second longitudinal rods; and

a second base member operably secured to said distal end portion of each of said first and second longitudinal rods;

wherein each of said first and second base members comprises a cross bar, said cross bar comprising first and second screw mounts integrally formed with and situated between a rod-shaped center section, a first rod-shaped outer section, and a second rod-shaped outer section.

6. The spinal platform of claim 5 further comprising:

first and second pivot members for securing said first base member to said first and second longitudinal rails, said first pivot member including separate channels for receiving said second longitudinal rail and said first outer section of said first base member, said second pivot member including separate channels for receiving said first longitudinal rail and said second outer section of said first base member; and

third and fourth pivot members for securing said second base member to said first and second longitudinal rails, said third pivot member including separate channels for receiving said second longitudinal rail and said first outer section of said second base member, said fourth pivot member including separate channels for receiving said first longitudinal rail and said second outer section of said second base member.

7. The spinal platform of claim 1 further comprising:

a micromanipulator operably coupled to said carriage member, said micromanipulator for guiding the surgical instrument along a constrained trajectory; and

a pump operably connected to said micromanipulator, said pump for delivering the therapeutic agent to the surgical instrument.

8. The spinal platform of claim 5 further comprising:

a first tissue retracting member operably connected to said first base member; and

a second tissue retracting member operably connected to said second base member;

wherein each of said first and second tissue retracting members comprises opposable first and second retracting arms having a distal end portion and a proximal end portion, said distal end portion of each of said first and second retracting arms including a removable tissue retractor blade extending axially therefrom.

9. The spinal platform of claim 1, wherein said carriage member further comprises:

a main body having oppositely disposed first and second major surfaces, said second major surface including oppositely disposed first and second tracks;

a bowl-shaped channel extending between said first and second major surfaces; and

a plurality of oppositely disposed locking mechanisms attached to said main body.

10. The spinal platform of claim 2, wherein said brace member further comprises:

a gondola slidably mounted to and axially situated between said first and second longitudinal rails of said brace member, said gondola comprising first and second parallel tracks, each of said first and second parallel tracks having first and second ends integrally formed with first and second cylindrical mating portions, each of said first and second cylindrical mating portions including a groove for receiving said first and second longitudinal rails, respectively.

11. The spinal platform of claim 10, wherein said gondola is slidably mounted to said carriage member so that said first and second tracks of said carriage member are mated with said first and second parallel tracks of said gondola, respectively.

12. The spinal platform of claim 1, said universal joint further comprising:

a spherical member including oppositely disposed tubular members integrally formed with said spherical member, said spherical member including a channel that extends between said tubular members through said spherical member.

13. The spinal platform of claim 1, said universal joint further comprising:

an upper platform having oppositely disposed first and second major surfaces;

a bowl-shaped lower portion for mating with said carriage member, said lower portion being integrally formed with said second major surface of said upper portion; and

a channel extending from said first surface of said upper platform through said lower portion.

14. A method for delivering a therapeutic agent to a spinal cord target, said method comprising the steps of:

providing a spinal platform, the spinal platform comprising a brace member for attachment to a plurality of bony structures surrounding at least a portion of the spinal cord target, a carriage member operatively coupled to and movable along the brace member, and a universal joint seated within a portion of the carriage member, the brace member comprising at least one longitudinal rail and a plurality of attachment members operably connected to the at least one longitudinal rail;

attaching the plurality of attachment members to first and second bony structures that surround at least a portion of the spinal cord target so that the carriage member is positioned substantially adjacent the spinal cord target;

manipulating the universal joint to adjust the coronal or sagittal angle of the surgical instrument; and

delivering the therapeutic agent to the spinal cord target via the surgical instrument.

15. The method of claim 14 further comprising the steps of:

attaching a micromanipulator to the universal joint;

connecting a pump to the micromanipulator;

operating the micromanipulator to drive the surgical instrument along a constrained trajectory to the spinal cord target; and

activating the pump so that the therapeutic agent is delivered to the spinal cord target via the surgical instrument.

16. The method of claim 14, wherein the step of providing a spinal platform further comprises the step of:

providing a brace member comprising oppositely disposed first and second longitudinal rails and a plurality of attachment members operably connected to and extending between the first and second longitudinal rails.

17. The method of claim 14 further comprising the step of:

surgically exposing the first and second bony structures;

attaching first and second clamp members to a portion of each of the first and second bony structures, respectively;

wherein each of the first and second clamp members comprises a T-shaped clamp body, the clamp body comprising a receptacle portion and an arm portion extending radially from the receptacle portion, the receptacle portion including first and second openings for receiving the first and second longitudinal rails, respectively, the arm portion including an axially-extending channel;

an L-shaped clamp pin having a first end and a contacting portion, the first end for insertion into the axially-extending channel; and

a clamp fastener for mating with the first end of the clamp pin to secure the clamp pin to the receptacle portion.

18. The method of claim 14, wherein said step of attaching the plurality of attachment members to first and second bony structures further comprises the steps of:

providing first and second tissue retracting members, the tissue retracting members comprising opposable first and second retracting arms having a distal end portion and a proximal end portion, the distal end portion of each of the first and second retracting arms including a removable tissue retractor blade extending axially therefrom;

positioning the first and second tissue retracting members adjacent the first and second bony structures, the first and second bony structures including first and second vertebrae;

inserting a plurality of self-tapping screws through a portion of each of the first and second tissue retracting members so that the screws are securely embedded in the lamina of the first and second vertebrae;

operating the first and second tissue retracting members so that the first and second retractor arms are moved apart from one another and spread the tissue surrounding the spinal cord target;

mating the brace member to the first and second tissue retracting members via the first and second base members, respectively;

operatively coupling the carriage member with the brace member; and

mating the universal joint with the carriage member.

19. The method of claim 14, wherein said step of providing a spinal platform further comprises the step of:

providing a carriage member comprising a main body having oppositely disposed first and second major surfaces, a bowl-shaped channel extending between the first and second major surfaces, and a plurality of oppositely disposed locking mechanisms attached to the main body, the second major surface including oppositely disposed first and second tracks.

20. The method of claim 14, wherein said step of providing a spinal platform further comprises the step of:

providing a universal joint comprising a spherical member including oppositely disposed tubular members integrally formed with the spherical member, the spherical member including a channel that extends between the tubular members through the spherical member.

21. The method of claim 18, wherein said step of operatively coupling the carriage member with the brace member further comprises the steps of:

providing a gondola, the gondola comprising first and second parallel tracks, each of the first and second parallel tracks having first and second ends integrally formed with first and second cylindrical mating portions, each of the first and second cylindrical mating portions including a groove;

mating the first and second cylindrical mating portions of the gondola with the first and second longitudinal rails, respectively; and

mating the carriage member with the gondola.