RETRACTOR CANNULA SYSTEM FOR ACCESSING AND VISUALIZING SPINE AND RELATED METHODS

• US 20120016260A1
• Filed: 09/26/2011
• Published: 01/19/2012
• Est. Priority Date: 10/20/2008
• Status: Active Grant

• Current Assignee: Expanding Innovations Inc.
• Original Assignee: Spine View, Inc.
• Inventors: To, John T.
• Granted Patent: US 8,888,813 B2
• Time in Patent Office: Days
• US Class Current: 600/562
• CPC Class Codes: A61B 1/3135 for examination of the epidural or the spinal space
• CPC Class Codes: A61B 10/06 Biopsy forceps , e.g. with cup-shaped jaws
• 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 17/3417 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 2017/00907 for light
• CPC Class Codes: A61B 2017/320064 with tissue or sample retaining means
• CPC Class Codes: A61B 2017/3419 Sealing means between cannula and body
• CPC Class Codes: A61B 5/0084 for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras

Abstract

Retractor cannula systems may be used for accessing and visualizing the spine and related methods of treatment, including a forward-looking retractor cannula system for creating a working space and the retractor cannula system having atraumatic dissection capability to allow visualization in spine. The devices and methods described may be used, for example, to perform annulus repair, herniated disc excision, and denervation of neurological tissue; to dispense pharmacological agents and/or cell or tissue therapy agents; to diagnose disc degeneration and bony degeneration, spinal stenosis, and nucleus decompression, and to perform disc augmentation.

Claims

1. A retractor cannula device comprising:

a tubular assembly comprising at least one lumen configured to hold an endoscopic system; and

a retractor assembly located at the distal end of the tubular assembly, wherein the retractor assembly comprises a first element with a convex outer surface and a concave inner surface, and a second element with a convex outer surface and a concave inner surface, wherein the first and second elements comprise an optically transparent material and at least one of the elements is pivotable with respect to the tubular assembly, and wherein the retractor assembly further comprises a first closed configuration and a second open configuration.

2. The device of claim 1, wherein the first and second elements are each pivotably attached to the tubular assembly at first and second side regions and at a central region.

3. The device of claim 2, wherein the tubular assembly comprises an inner shaft slidably retained within the lumen, and one or more pins pivotably attaching the first and second side regions of the first and second elements to the inner shaft.

4. The device of claim 3, wherein in the first closed configuration, the inner shaft is in a first longitudinal location and in the second open configuration, the inner shaft is in a second longitudinal location distal to the first location.

5. The device of claim 2, wherein the central regions of the first and second elements are attached using flexible hinge structures.

6. The device of claim 2, wherein the first and second elements have the same longitudinal length.

7. The device of claim 2, wherein in the first closed configuration an inner edge of the first element and an inner edge of the second element form a first angle, and wherein in the second open configuration the inner edge of the first element and the inner edge of the second element form a second angle that is greater than the first angle.

8. The device of claim 2, wherein in the first closed configuration, an inner edge of the first element contacts an inner edge of the second element, and in the second open configuration, the inner edge of the first element does not contact the inner edge of the second element.

9. The device of claim 8, wherein the rounded distal end of the first and second elements has a semi-elliptical profile.

10. The device of claim 9, wherein a surface of the first and second elements is curved.

11. The device of claim 10, wherein the curved surface of the first and second elements is tapered from a proximal portion to a distal portion of the first and second elements.

12. The device of claim 11, wherein the proximal portion of the first and second elements has a first taper angle and the distal portion has a second taper angle.

13. The device of claim 12, wherein the first taper angle is different from the second taper angle.

14. The device of claim 13, wherein the first taper angle is less than the second taper angle.

15. The device of claim 12, wherein the first taper angle is the same as the second taper angle.

16. The device of claim 1, wherein the first element is pivotable with respect to the tubular assembly wherein the first element is pivotably attached to the tubular assembly by one or more pins on either side of the first element and a flexible hinge connecting the top side of the first element to the tubular assembly, and wherein the second element is fixed with respect to the tubular assembly.

17. The device of claim 16, wherein the longitudinal length of the second element is longer than the longitudinal length of the first element.

18. The device of claim 17, wherein the first element comprises an angled distal tip, and wherein in the first closed configuration, the first element is pivoted such that the distal tip extends across a longitudinal midline of the retractor assembly, and in the second open configuration, the first element is pivoted such that the distal tip does not cross the longitudinal midline.

19. The device of claim 1, further comprising an endoscopic system.

20. A method for contacting and visualizing spinal tissue comprising:

advancing an introducer cannula toward a spine;

inserting an endoscope into a retractor cannula, wherein the retractor cannula comprises a tubular assembly comprising at least one lumen configured to hold an endoscope, and a retractor assembly located at the distal end of the tubular assembly, wherein the retractor assembly comprises a first element with a convex outer surface and a concave inner surface, and a second element with a convex outer surface and a concave inner surface, wherein the first and second elements comprise an optically transparent material and at least one of the elements is pivotable with respect to the tubular assembly, and wherein the retractor assembly further comprises a first closed configuration and a second open configuration;

viewing surrounding structure through the optically transparent material of the first and second elements using the endoscope, while the retractor cannuls is the in the first closed configuration; and

advancing the retractor cannula into and out of the introducer cannula in the first closed configuration.

21. The method of claim 20, further comprising advancing an inner shaft of the tubular assembly to move the retractor assembly from the first closed configuration to the second open configuration.

22. The method of claim 20, further comprising partially closing the retractor assembly against a target structure.

23. The method of claim 22, further comprising:

inserting a tissue removal device into the retractor assembly; and

removing tissue from the target structure using the tissue removal device.

24. The method of claim 20, wherein viewing surrounding structures through the optically transparent material is performed simultaneously with advancing the retractor cannula.