DILATOR WITH DIRECT VISUALIZATION

• US 20110098531A1
• Filed: 04/16/2010
• Published: 04/28/2011
• Est. Priority Date: 04/20/2009
• Status: Active Grant

• Current Assignee: Expanding Innovations Inc.
• Original Assignee: Spine View, Inc.
• Inventors: To, John T.
• Granted Patent: US 8,343,035 B2
• Time in Patent Office: Days
• US Class Current: 600/114
• CPC Class Codes: A61B 1/3135 for examination of the epidural or the spinal space
• CPC Class Codes: A61B 1/32 Devices for opening or enlarging the visual field, e.g. of a tube of the body dilators A61M29/00
• 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 17/1671 for the spine
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/295 combined with cutting implements
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00309 Cut-outs or slits
• CPC Class Codes: A61B 2017/00902 transparent or translucent
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/2939 Details of linkages or pivot points
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2017/3456 blunt
• CPC Class Codes: A61B 2017/3458 threaded
• CPC Class Codes: A61B 2090/3614 using optical fibre

Abstract

Dilators with a threaded distal portion and direct visualization capability may be used for penetrating and dilating stiff tissues and bones. The threaded portion of a dilator engages the tissue between the insertion site and the target site, and may be rotated for advancing through the target tissue in a more controlled fashion. The direct visualization capability may be used to visualize the ligament as the threaded distal portion passes through the ligamentum flavum. The devices and methods described may be used in procedures, for example, where ligaments surrounding the epidural space need to be dilated in order to deliver one or more surgical instruments into the epidural space.

Claims

1. A method for dilating a target tissue, comprising:

introducing a dilating device having a distal threaded portion and an endoscope removably located in a longitudinal lumen of said dilating device;

advancing the dilating device axially until the thread portion engages the target tissue;

rotating the dilating device while visualizing the target tissue using said endoscope until the distal end of the dilating device passes through the target tissue.

2. The method of claim 1, wherein said endoscope is a fiberscope, rod lens scope or “

camera on tip”

scope.

3. The method of claim 1, wherein said distal threaded portion of said dilating device is optically transparent.

4. The method of claim 1, wherein said distal threaded portion of said dilating device is optically translucent.

5. The method of claim 1, wherein said dilating device is optically transparent.

6. The method of claim 1, wherein said dilating device is optically translucent.

7. A method for treating intervertebral disc defects in a spine, comprising:

introducing a dilating device having a distal threaded portion and an endoscope removably located in a longitudinal lumen of said dilating device;

advancing the dilating device axially until the thread portion engages the ligamentum flavum;

rotating said dilating device to dilate ligament enclosing the epidural space while visualizing the ligament using said endoscope until said dilating device passes through the ligament flavum;

advancing a cannula device over the dilating device into the epidural space to a target site;

proximally withdrawing the endoscope from the dilating device,

proximally withdrawing the dilating device; and

introducing a therapy device into said cannula device to treat a disc defect.

8. The method of claim 7, wherein said endoscope is a fiberscope, rod lens scope or “

camera on tip”

scope.

9. The method of claim 7, wherein said threaded distal portion of said dilating device is optically transparent.

10. The method of claim 7, further comprising inserting a stylet into said cannula device before introducing said therapy device.

11. The method of claim 10, further comprising penetrating an annular wall of the intervertebral disc with said stylet in order to acquire access to the target site.

12. The method of claim 11, further comprising withdrawing said stylet before introducing said therapy device.

13. The method of claim 7, wherein said cannula comprises a curved distal portion.

14. The method of claim 7, wherein said therapy device is a tissue removal device.

15. The method of claim 7, wherein said therapy device is a cable-based tissue removal device.

16. A method for treating intervertebral disc defects in a spine of a body, comprising:

making in incision into a skin of the body;

introducing a dilating device having a distal threaded portion and an endoscope removably located in a longitudinal lumen of said dilating device to the ligamentum flavum;

dilating the ligament by rotating the dilating device while visualizing the ligament until the distal end of the dilating device passes through the ligamentum flavum;

introducing a cannula device over the dilating device to a portion of the spine;

proximally withdrawing the endoscope;

proximally withdrawing the dilating device;

introducing a therapy device into the cannula device to treat a disc defect; and

treating the disc defect.