Screw delivery system and method
DC CAFCFirst Claim
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1. A screw delivery system kit, comprising:
- an outer cannula having a first exterior surface and a first interior surface defining a bore, the first interior surface having a first inner diameter and the first exterior surface having a first outer diameter, the surfaces extending along a first length on a first axis between a first proximal end having a first stop and a first distal end;
a trocar having a second exterior surface with a second outer diameter, the second exterior surface extending along a second length on a second axis between a second proximal end having a second stop and a second distal end defining a blunt tip;
a guide having a handle and a tube, the tube having a third exterior surface and a third interior surface defining a passageway, the third interior surface having a third inner diameter and the third exterior surface having a third outer diameter, the third interior surface extending between a third proximal end and a third distal end, the third exterior surface extending along a third length on a third axis between a third stop at the third proximal end and the third distal end, the handle being connected to the tube at an angle to the third axis;
a bone drill bit having a fourth exterior surface with a fourth outer diameter extending along a fourth length on a fourth axis between a fourth stop located near a fourth proximal end and a plurality of drilling flutes defined on a fourth distal end;
a bone tap having a fifth exterior surface with a fifth outer diameter extending between a fifth stop located near a fifth proximal end and a fifth distal end having threading thereon for tapping an opening in bone created by said bone drill bit;
an adjustable length stop having a length, the adjustable length stop being a series of interconnected cylindrical elements;
a cutter for adjusting the length of said adjustable length stop; and
, an implant driver for inserting a screw.
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Abstract
A screw delivery system and method are disclosed for use in a variety of surgical indications. The screw delivery system generally comprises an outer cannula, a guide, and various interventional devices such as bone drill bits and taps as well as an implant driver for inserting a screw. The method disclosed varies by indication, but is ordinarily intended for use as a minimally invasive procedure which is a combination of percutaneous and open techniques wherein a small midline incision is made over a surgical site and the screw delivery system provides a percutaneous portal through an incision distant from the small midline incision over the surgical site.
504 Citations
31 Claims
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1. A screw delivery system kit, comprising:
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an outer cannula having a first exterior surface and a first interior surface defining a bore, the first interior surface having a first inner diameter and the first exterior surface having a first outer diameter, the surfaces extending along a first length on a first axis between a first proximal end having a first stop and a first distal end;
a trocar having a second exterior surface with a second outer diameter, the second exterior surface extending along a second length on a second axis between a second proximal end having a second stop and a second distal end defining a blunt tip;
a guide having a handle and a tube, the tube having a third exterior surface and a third interior surface defining a passageway, the third interior surface having a third inner diameter and the third exterior surface having a third outer diameter, the third interior surface extending between a third proximal end and a third distal end, the third exterior surface extending along a third length on a third axis between a third stop at the third proximal end and the third distal end, the handle being connected to the tube at an angle to the third axis;
a bone drill bit having a fourth exterior surface with a fourth outer diameter extending along a fourth length on a fourth axis between a fourth stop located near a fourth proximal end and a plurality of drilling flutes defined on a fourth distal end;
a bone tap having a fifth exterior surface with a fifth outer diameter extending between a fifth stop located near a fifth proximal end and a fifth distal end having threading thereon for tapping an opening in bone created by said bone drill bit;
an adjustable length stop having a length, the adjustable length stop being a series of interconnected cylindrical elements;
a cutter for adjusting the length of said adjustable length stop; and
,an implant driver for inserting a screw. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A method of inserting a screw into vertebral bone in the lumbar region or the spine, comprising:
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making an incision for percutaneous access to a surgical site;
inserting an outer cannula having a bore defined between a proximal end and a distal end and a trocar through the bore into the incision;
advancing the outer cannula and trocar toward the surgical site until the distal end of the outer cannula is positioned adjacent the surgical site;
removing the trocar from the outer cannula;
forming an opening through a first lumbar vertebra and into a second lumbar vertebra;
delivering a screw through the bore of the outer cannula to the surgical site; and
screwing the screw into the opening through the first lumbar vertebra and into the second lumbar vertebra. - View Dependent Claims (10, 11, 12, 13, 14, 15, 16, 17, 22, 23)
17.The method of claim 16, wherein the two screws are engaged across the lumbar facet joint in a cross-over configuration. -
17. The method of claim 13, wherein the opening through the first lumbar vertebra extends from the posterior spinous process and through the lamina to the lumbar facet joint.
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22. The method of claim 13, wherein the screwing comprises transarticular screw fixation cross the lumbar facet joint.
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23. The method of claim 9, wherein the access incision is remote from the surgical site;
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wherein the method further comprises making a second incision over the surgical site for viewing the surgical site.
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- 18. The method of claim 18, wherein the opening through the first lumbar vertebra extends from the contralateral side of the posterior spinous process.
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20. The method of claim 20, wherein the opening into the second lumbar vertebra extends from superior articular process.
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21. The method of claim 21, wherein the opening extends through the second lumbar vertebra from the superior articular process to the base of the transverse process and pars interarticularis.
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24. A method of facilitating interbody fusion between a first vertebra and a second vertebra, comprising:
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making an incision for percutaneous access to a surgical site;
inserting an outer cannula having a bore defined between a proximal end and a distal end and a trocar through the bore into the incision;
advancing the outer cannula and trocar toward the surgical site until the distal end of the outer cannula is positioned adjacent the surgical site;
removing the trocar from the outer cannula;
forming an opening through the first vertebra and into the second vertebra;
delivering a screw through the bore of the outer cannula to the surgical site;
screwing the screw into the opening through the first vertebra and into the second vertebra; and
positioning at least one interbody fusion implant between the first and second vertebrae.
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- 25. The method of claim 25, further comprising tapping the opening before screwing the screw into the opening.
- 27. The method of claim 27, wherein the first and second vertebrae are lumbar vertebrae.
Specification