TRANSPEDICULAR ACCESS TO INTERVERTEBRAL SPACES AND RELATED SPINAL FUSION SYSTEMS AND METHODS

• US 20120265250A1
• Filed: 03/16/2012
• Published: 10/18/2012
• Est. Priority Date: 03/18/2011
• Status: Active Grant

• Current Assignee: RAED M Ali MD Incorporated
• Original Assignee: RAED M Ali MD Incorporated
• Inventors: Ali, Raed
• Granted Patent: US 8,790,375 B2
• Time in Patent Office: Days
• US Class Current: 606/279
• CPC Class Codes: A61B 17/1617 with mobile or detachable parts
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/7001 Screws or hooks combined with longitudinal elements which do not contact vertebrae A61B17/7058 takes precedence
• CPC Class Codes: A61B 17/7032 Screws or hooks with U-shaped head or back through which longitudinal rods pass
• CPC Class Codes: A61B 17/7064 Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor
• CPC Class Codes: A61B 17/86 Pins or screws or threaded wires; nuts therefor A61B17/72 take precedence
• CPC Class Codes: A61B 2017/564 Methods for bone or joint treatment
• CPC Class Codes: A61F 2/441 made of inflatable pockets or chambers filled with fluid, e.g. with hydrogel
• CPC Class Codes: A61F 2/442 Intervertebral or spinal discs, e.g. resilient non-disc-shaped intervertebral inflatable pockets A61F2/441; non-disc-shaped intervertebral fusion implants A61F2/4455
• CPC Class Codes: A61F 2/4425 made of articulated components
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2/482 Electrical means
• CPC Class Codes: A61F 2/484 Fluid means, i.e. hydraulic or pneumatic
• CPC Class Codes: A61F 2002/30092 using shape memory or superelastic materials, e.g. nitinol
• CPC Class Codes: A61F 2002/30289 helically-coiled
• CPC Class Codes: A61F 2002/30364 Rotation about the common longitudinal axis
• CPC Class Codes: A61F 2002/30365 with additional means for limiting said rotation
• CPC Class Codes: A61F 2002/30367 with additional means for preventing said rotation
• CPC Class Codes: A61F 2002/30471 connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
• CPC Class Codes: A61F 2002/30484 : Mechanically expandable devices located on the first prosthetic part for locking into or onto the second prosthetic part
• CPC Class Codes: A61F 2002/30579 : with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/30581 : having a pocket filled with fluid, e.g. liquid
• CPC Class Codes: A61F 2002/30583 : filled with hardenable fluid, e.g. curable in-situ
• CPC Class Codes: A61F 2002/30588 : filled with solid particles
• CPC Class Codes: A61F 2002/4415 : elements of the prosthesis being arranged in a chain like manner
• 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 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys

Abstract

According to some embodiments, a method of accessing an intervertebral space of a patient'"'"'s spine in a minimally invasive manner compromises creating a passage from a posterior end of a pedicle of a vertebral member using a probe, advancing the probe through the pedicle and to a main body portion of the vertebral member, advancing the probe through a superior endplate of the vertebral member and into the intervertebral space and enlarging the passage using at least one tap to create an enlarged passage from a posterior of the pedicle to the intervertebral space. In some embodiments, the enlarged passage traverses at least three cortical layers of the vertebral member.

Claims

1. A method of fusing a first vertebra to a second vertebra, said second vertebra being immediately adjacent and above the first vertebra, the method comprising:

creating a passage from a posterior end of a pedicle of the first vertebra through a superior endplate of the first vertebra, such that the passage extends into an intervertebral space located generally between the first and second vertebrae;

removing native tissue located within the intervertebral space by advancing a tissue removal tool through the passage and selectively moving said tissue removal tool within the intervertebral space;

delivering at least one of an implant and a grafting material through the passage, wherein said implant or grafting material is configured to promote fusion between the superior endplate of the first vertebra and an inferior endplate of the second vertebra; and

advancing a first bone screw through the passage, such that a distal end of the first bone screw extends at least partially into the intervertebral space.

2. The method of claim 1, wherein the passage created through the first vertebra is generally linear.

3. The method of claim 1, wherein the method is performed minimally invasively.

4. The method of claim 1, wherein the implant comprises an expandable implant.

5. The method of claim 1, wherein removing native material comprises removing at least one of disc material and a surface of an endplate of the first vertebra or the second vertebra.

6. The method of claim 1, wherein the tissue removal tool comprises an expandable head portion, said head portion being configured to assume a collapsed positioned during advancement through the passage and being configured to selectively assume an expanded position within the intervertebral space.

7. The method of claim 1, further comprising inserting an access device within the passage to facilitate the movement of tools or devices through the passage.

8. The method of claim 1, further comprising inserting a second bone screw through the second vertebra.

9. The method of claim 8, further comprising connecting the first bone screw to the second bone screw using a rod or other connector.

10. The method of claim 8, wherein the second bone screw does not extend through an endplate of the second vertebra.

11. The method of claim 1, further comprising inserting a facet implant in at least one of the facet joints between the first and second vertebrae to fuse the first and second vertebrae at the at least one of the facet joints.

12. The method of claim 11, wherein the facet implant is configured to selectively distract adjacent surfaces of the first and second vertebrae.

13. The method of claim 11, further comprising securing the first bone screw to at least a portion of the facet implant.

14. A method of fusing a first vertebra to a second vertebra, said second vertebra being immediately adjacent and above the first vertebra, the method comprising:

creating a passage from a posterior end of a pedicle of the first vertebra through a superior endplate of the first vertebra, such that the passage extends into an intervertebral space located generally between the first and second vertebrae;

advancing a first bone screw through the passage, such that a distal end of the first bone screw extends at least partially into the intervertebral space;

inserting a second bone screw through the second vertebra; and

attaching the first bone screw to the second bone screw.

15. The method of claim 14, wherein the first bone screw and the second bone screw are attached using a rod or other interconnecting member.

16. The method of claim 14, wherein the passage created through the first vertebra is generally linear.

17. The method of claim 14, wherein the method is performed minimally invasively.

18. A method of fusing a first vertebra to a second vertebra, said second vertebra being immediately adjacent and above the first vertebra, the method comprising:

creating a passage from a posterior end of a first pedicle of the first vertebra through a superior endplate of the first vertebra, such that the passage extends into an intervertebral space located generally between the first and second vertebrae;

advancing a first bone screw through the passage, such that a distal end of the first bone screw extends at least partially into the intervertebral space; and

inserting a facet implant in a facet joints between the first and second vertebrae, said facet joint being adjacent the first pedicle;

wherein the first and second portions of the facet implant are fixed to one another to prevent relative movement between the first and second portions;

attaching the first portion of the facet implant to the first bone screw; and

attaching the second portion of the facet implant to the second vertebra.

19. The method of claim 18, further comprising delivering at least one of an implant and grafting material within the intervertebral space through the passage.

20. The method of claim 18, wherein attaching the second portion of the facet implant to the second vertebra comprises securing the second portion to the lamina of the second vertebra using at least one screw.