Methods and instrumentation for the surgical correction of human thoracic and lumbar spinal disease from the antero-lateral aspect of the spine
DC CAFCFirst Claim
1. A method for inserting an interbody intraspinal implant into a disc space between adjacent vertebrae located within a human thoracic and lumbar spine having an anterior aspect and a posterior aspect being divided by a plane through transverse processes of the adjacent vertebrae, and having a lateral aspect, the method comprising the steps of:
- penetrating from a position anterior to the transverse processes the lateral aspect of a spinal disc intermediate the adjacent vertebrae;
removing from between the adjacent vertebrae at least a portion of the spinal disc to form a laterally facing opening; and
inserting from a position anterior to the transverse processes of the adjacent vertebrae said implant into the laterally facing opening.
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Abstract
An improved method and instrumentation for performing spinal surgery, including discectomy, interbody fusion and rigid internal fixation of the spine, from the lateral aspect of the spine is disclosed. The surgical procedure can be performed through a very small incision. The instrumentation of the present invention, all of which is inserted from a lateral position into the spine in the preferred embodiment, comprises a guide pin, a distractor, an extended outer sleeve, an inner sleeve an adjustable drill and an implant driver. The distractor of the present invention is driven into the disc for spacing apart and realigning the adjacent vertebrae. It further functions as an alignment rod for inserting the extended outer sleeve which is a hollow tubular member capable of maintaining said spacing and alignment of two adjacent vertebrae and defines a protected space through which subsequent instruments which may include, but are not limited to, a drill and a diameter reducing inner sleeve may be passed, as well as a spinal implant. The remainder of the surgical procedure consisting of the removal of spinal material across the disc, fusion, and rigid internal stabilization via the implant may all be performed via the closed space within the extended outer sleeve.
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Citations
87 Claims
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1. A method for inserting an interbody intraspinal implant into a disc space between adjacent vertebrae located within a human thoracic and lumbar spine having an anterior aspect and a posterior aspect being divided by a plane through transverse processes of the adjacent vertebrae, and having a lateral aspect, the method comprising the steps of:
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penetrating from a position anterior to the transverse processes the lateral aspect of a spinal disc intermediate the adjacent vertebrae; removing from between the adjacent vertebrae at least a portion of the spinal disc to form a laterally facing opening; and inserting from a position anterior to the transverse processes of the adjacent vertebrae said implant into the laterally facing opening. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67)
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68. A method for inserting an interbody intraspinal implant into a disc space between adjacent vertebrae located within a human thoracic and lumbar spine having an anterior aspect and a posterior aspect being divided by a plane through transverse processes of the adjacent vertebrae, and having a lateral aspect, the method comprising the steps of:
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engaging from a position anterior to the transverse processes of the adjacent vertebrae into the lateral aspect of the spine a tubular member; removing from a position anterior to the transverse processes of the adjacent vertebrae at least a portion of the spinal disc through said tubular member to form a laterally facing opening; and inserting from a position anterior to the transverse processes of the adjacent vertebrae at least one implant into the laterally facing opening. - View Dependent Claims (69, 70, 71)
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72. A method for inserting an interbody intraspinal implant into a disc space between adjacent vertebrae located within a human thoracic and lumbar spine having an anterior aspect and a posterior aspect being divided by a plane through transverse processes of the adjacent vertebrae, and having a lateral aspect, the method comprising the steps of:
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driving from a position anterior to the transverse processes of the adjacent vertebrae toward the lateral aspect of a spinal disc intermediate the adjacent vertebrae an extended outer sleeve having means for penetrably engaging the spine along its lateral aspect; removing from a position anterior to the transverse processes of the adjacent vertebrae through said extended outer sleeve at least a portion of the spinal disc to create a space; and inserting from a position anterior to the transverse processes into the lateral aspect of the spine at least one implant, said implant occupying at least in part the space created by the removing step. - View Dependent Claims (73, 74, 75)
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- 76. The method of claim 76 in which the driving step includes the sub-step of penetrating the disc space with said engaging means, and wherein said engaging means includes a disc penetrating extension.
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78. A method for inserting an interbody spinal implant into a disc space between two adjacent vertebrae located within a human thoracic and lumbar spine having an anterior aspect and a posterior aspect being divided by a plane through transverse processes of the adjacent vertebrae, and having a lateral aspect, the method comprising the steps of:
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inserting from a position anterior to the transverse processes of the adjacent vertebrae a distractor into the lateral aspect of the disc space to provide for appropriate spacing apart of the adjacent vertebrae; inserting from a position anterior to the transverse processes of the adjacent vertebrae an extended outer sleeve into contact with the lateral aspect of the spine; driving said extended outer sleeve into engagement with the spine; removing said distractor; removing from a position anterior to the transverse processes of the adjacent vertebrae at least a portion of a spinal disc intermediate the adjacent vertebrae to form a lateral facing opening; inserting from a position anterior to the transverse processes of the adjacent vertebrae an implant into the disc space intermediate the adjacent vertebrae through the laterally facing opening; and removing the extended outer sleeve. - View Dependent Claims (79, 80, 81, 82, 83, 84, 85, 86, 87)
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Specification