Surgical instruments and method useful for endoscopic spinal procedures

• US 5,599,279 A
• Filed: 01/29/1996
• Issued: 02/04/1997
• Est. Priority Date: 03/16/1994
• Status: Expired due to Term

• Current Assignee: Gus J. Slotman, United States Surgical Corporation (Medtronic Plc), Sherman Stein
• Original Assignee: Gus J. Slotman, United States Surgical Corporation (Medtronic Plc), Sherman Stein
• Inventors: Stein, Sherman, Castro, Salvatore, Ratcliff, Keith, Slotman, Gus J., Green, David T., Mililli, Carlo A.
• Primary Examiner(s): Apley, Richard J.
• Assistant Examiner(s): FLANAGAN, BEVERLY MEINDL
• Application Number:
  US08/593,191
• Time in Patent Office: 372 Days
• Field of Search: 128/898, 128/20, 606/61, 606/130, 606/198, 600/201, 600/210, 600/217, 600/219, 600/235
• US Class Current: 600/201
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/2936 Pins in guiding slots
• CPC Class Codes: A61B 2017/2943 Toothed members, e.g. rack and pinion
• CPC Class Codes: A61B 2017/2944 Translation of jaw members
• 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 2/4455 for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages intervertebral discs A61F2/442
• CPC Class Codes: A61F 2002/4635 using minimally invasive surgery

Abstract

The present invention provides endoscopic instrumentation and surgical techniques especially useful for accessing at least a portion of an intervertebral disc. Vertebrae spreading instruments are provided for spreading adjacent vertebrae to facilitate access to the intervertebral disc are. The disclosed surgical method uses an anterior approach to access the intervertebral disc and spreads adjacent vertebrae utilizing an endoscopic vertebrae spreading instrument.

Claims

1. A method for accessing vertebral structures comprising:

forming an endoscopic channel on an anterior portion of a patient'"'"'s body;

inserting an endoscopic vertebrae spreading instrument into said endoscopic channel; and

spreading adjacent vertebrae in the spinal column using said endoscopic vertebrae spreading instrument.

2. A method for intervertebral disc removal comprising:

endoscopically accessing the spinal column through an anterior endoscopic port;

inserting an endoscopic spreading instrument into the endoscopic port;

spreading apart vertebrae adjacent an intervertebral disc using the endoscopic spreading instrument;

accessing an intervertebral disc nucleus; and

removing at least a portion of the disc nucleus through said anterior endoscopic port.

3. A method for intervertebral disc removal according to claim 2 wherein the step of accessing an intervertebral disc nucleus includes removal of a portion of an intervertebral disc annulus.

4. A method for intervertebral disc removal according to claim 2 further comprising the step of cutting the disc nucleus with an endoscopic cutting instrument prior to the step of removing at least a portion of said disc nucleus through said anterior endoscopic port.

5. The method for intervertebral disc removal according to claim 2, wherein the step of spreading apart vertebrae includes positioning at least two vertebrae spreading arm members of said endoscopic spreading instrument between adjacent vertebrae and moving said arm members to an open position to spread the vertebrae.

6. The method for intervertebral disc removal according to claim 5, wherein the step of spreading apart vertebrae includes initially positioning said arm members of said endoscopic spreading instrument between the vertebrae such that exterior tissue contacting surfaces contact the vertebrae and thereafter moving said arm members to said open position to spread the vertebrae.

7. The method for intervertebral disc removal according to claim 6, wherein the step of spreading apart vertebrae includes pivoting said arm members from a closed position to said open position.

8. The method for intervertebral disc removal according to claim 5, wherein the step of spreading apart vertebrae includes actuating an actuating mechanism of said endoscopic spreading instrument to move said arm members to said open position thereof.

9. The method for intervertebral disc removal according to claim 8, wherein the step of actuating the actuating mechanism includes rotating a rotatable control knob of said actuating mechanism to move said arm members to said open position.

10. The method for intervertebral disc removal according to claim 5, wherein the step of spreading apart vertebrae includes initially positioning said arm members between adjacent vertebrae such that said arm members are in general parallel relation with a longitudinal axis defined by said endoscopic spreading instrument and thereafter moving said arm members in an opposed direction to said open position to spread the vertebrae.

11. The method for intervertebral disc removal according to claim 10, wherein the step of spreading apart vertebrae includes moving said arm members in the transverse direction to said open position while maintaining the parallel relation of said arm members with said longitudinal axis.

12. The method for intervertebral disc removal according to claim 8 wherein the step of actuating the actuating mechanism reciprocates an actuating rod interfitting with one of said arm members.