Method and apparatus for spinal distraction

• US 7,473,256 B2
• Filed: 10/22/2004
• Issued: 01/06/2009
• Est. Priority Date: 10/23/2003
• Status: Active Grant

• Current Assignee: Mis Ip Holdings LLC
• Original Assignee: TranS1 Incorporated (Baxano Surgical, Inc.)
• Inventors: Cragg, Andrew L., Assell, Robert L., Ainsworth, Steven D., Dickhudt, Eugene A.
• Primary Examiner(s): Robert; Eduardo C
• Assistant Examiner(s): WOODALL, NICHOLAS W
• Application Number:
  US10/971,765
• Publication Number:
  US 20050137602A1
• Time in Patent Office: 1,537 Days
• Field of Search: 606/61, 606/90
• US Class Current: 606/90
• 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 17/025 Joint distractors
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1615 Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/1697 specially adapted for wire insertion
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/7074 Tools specially adapted for spinal fixation operations other than for bone removal or filler handling A61B17/7062, A61B17/808, A61B17/8858 take precedence; for spinal image producing devices A61B90/36, A61B34/20; markers A61B90/39
• CPC Class Codes: A61B 17/8615 at the central region of the screw head
• CPC Class Codes: A61B 17/888 the driver bit acting on the central region of the screw head
• CPC Class Codes: A61B 17/8888 at its central region
• CPC Class Codes: A61B 17/8897 Guide wires or guide pins
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable for prosthetic joint-implanting tools A61F2/4603
• CPC Class Codes: A61B 2017/00469 for insertion of instruments, e.g. guide wire, optical fibre
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22044 with a pointed tip
• CPC Class Codes: A61B 2017/3445 used as instrument channel for multiple instruments catheters A61B2017/22072
• CPC Class Codes: A61B 2017/922 Devices for impaction, impact element

Abstract

Disclosed are surgical tools, tool sets and methods for percutaneously accessing and preparing treatment sites within the spine for subsequent treatment procedures. The treatment site may be an inter-vertebral motion segments in the lumbar and sacral regions of the spine. The tool set may comprise introducer tools and bone dilators for accessing and tapping into a targeted site, such as, for example, the anterior surface of the S1 vertebral body. The tool set may also comprise cutters and extractors for preparing the treatment site for subsequent treatment procedures. The tool set may additionally comprise a bone graft inserter, an exchange system, and/or a temporary distraction tool for further preparing the treatment site for subsequent treatment procedures.

Claims

1. A method of treating the spine, comprising the steps of:

identifying a site on the anterior surface of the sacrum;

forming a lumen from the site into the sacrum, through a first vertebral body and into a second vertebral body;

introducing a temporary distraction device into the lumen, the temporary distraction device comprising a proximal piece releasably connectable with a distal piece, the proximal piece having a proximal external thread with a proximal thread pitch, the distal piece having a distal external thread with a distal thread pitch that is finer than the proximal thread pitch;

increasing the distance between the first and second vertebral body by rotating the proximal external thread into engagement with the first vertebral body and rotating the distal external thread into engagement with the second vertebral body;

releasing the connection between the proximal piece and the distal piece; and

sequentially removing the proximal piece and the distal piece of the temporary distraction device from the lumen.

2. A method of treating the spine as in claim 1, wherein the lumen extends at least as far as the L5 vertebrae.

3. A method of treating the spine as in claim 2, wherein the lumen is linear.

4. A method of treating the spine as in claim 1, wherein the forming step comprises drilling.

5. A method of treating the spine as in claim 1, wherein the method additionally comprises removing at least a part of a disc from between the first and the second vertebral bodies.

6. A method of treating the spine as in claim 1, wherein the method additionally comprises removing an entire nucleus from between the first and the second vertebral bodies.

7. A method of treating the spine as in claim 1, wherein the lumen comprises a longitudinal axis and the increasing the distance between the first and second vertebral body occurs along the longitudinal axis of the lumen.

8. A method of treating the spine as in claim 1, wherein the proximal piece and the distal piece are moveable with respect to each other prior to releasing the connection between the proximal and the distal piece.

9. A method of treating the spine as in claim 1, wherein the proximal piece further comprises a cavity with an internal unthreaded segment configured to facilitate temporary engagement with an insertion tip of an insertion assembly.

10. A method of treating the spine as in claim 1, wherein the distal piece further comprises a cavity with an internal unthreaded segment configured to facilitate temporary engagement with an insertion tip of an insertion assembly.

11. A method of treating the spine as in claim 1, wherein the proximal piece further comprises a cavity with an internal threaded segment configured to facilitate temporary engagement with an extraction tip of an extraction assembly.

12. A method of treating the spine as in claim 1, wherein the distal piece further comprises a cavity with an internal threaded segment configured to facilitate temporary engagement with an extraction tip of an extraction assembly.

13. A method of treating the spine as in claim 1, wherein the increasing the distance between the first and second vertebral body comprises temporarily engaging an insertion tip of an insertion assembly with an internal unthreaded segment of the proximal piece and an internal unthreaded segment of the distal piece and rotating the insertion tip.

14. A method of treating the spine as in claim 13, wherein rotation of the insertion tip is continued until the desired degree of distraction between the first vertebral body and the second vertebral body is achieved.

15. A method of treating the spine as in claim 1, wherein the sequentially removing the proximal piece of the temporary distraction device comprises temporarily engaging an extraction tip of an extraction assembly with an internal threaded segment of the proximal piece and rotating the extraction tip.

16. A method of treating the spine as in claim 1, wherein the sequentially removing the distal piece of the temporary distraction device comprises temporarily engaging an extraction tip of an extraction assembly with an internal threaded segment of the distal piece and rotating the extraction tip.

17. A method of treating the spine, comprising the steps of:

identifying a site on the anterior surface of the sacrum;

forming a lumen from the site into the sacrum, through a first vertebral body and into a second vertebral body;

introducing a temporary distraction device into the lumen, the distraction device comprising a distal portion and a proximal portion, the proximal having a proximal external thread with a proximal thread pitch, the distal portion having a distal external thread with a distal thread pitch that is greater than the proximal thread pitch;

rotating the proximal external thread into engagement with the first vertebral body and rotating the distal external thread into engagement with the second vertebral body to increase the distance between the first and second vertebral body; and

removing the temporary distraction device from the lumen.

18. A method of treating the spine as in claim 17, wherein the lumen extends at least as far as the L5 vertebrae.

19. A method of treating the spine as in claim 17, wherein the lumen is linear.

20. A method of treating the spine as in claim 17, wherein the forming step comprises drilling.

21. A method of treating the spine as in claim 17, wherein the method additionally comprises removing at least a part of a disc from between the first and the second vertebral bodies.

22. A method of treating the spine as in claim 17, wherein the method additionally comprises removing an entire nucleus from between the first and the second vertebral bodies.

23. A method of treating the spine as in claim 17, wherein the lumen comprises a longitudinal axis and the increasing the distance between the first and second vertebral body occurs along the longitudinal axis of the lumen.

24. A method of treating the spine as in claim 17, further comprising separating the distal portion from the proximal portion.

25. A method of treating the spine as in claim 17, wherein the proximal piece and the distal piece are moveable with respect to each other prior to releasing the connection between the proximal and the distal piece.

26. A method of treating the spine as in claim 17, wherein the proximal piece further comprises a cavity with an internal unthreaded segment configured to facilitate temporary engagement with an insertion tip of an insertion assembly.

27. A method of treating the spine as in claim 17, wherein the distal piece further comprises a cavity with an internal unthreaded segment configured to facilitate temporary engagement with an insertion tip of an insertion assembly.

28. A method of treating the spine as in claim 17, wherein the proximal piece further comprises a cavity with an internal threaded segment configured to facilitate temporary engagement with an extraction tip of an extraction assembly.

29. A method of treating the spine as in claim 17, wherein the distal piece further comprises a cavity with an internal threaded segment configured to facilitate temporary engagement with an extraction tip of an extraction assembly.

30. A method of treating the spine as in claim 17, wherein the rotating the proximal external thread into engagement with the first vertebral body comprises temporarily engaging an insertion tip of an insertion assembly with an internal unthreaded segment of the proximal piece and an internal unthreaded segment of the distal piece and rotating the insertion tip.

31. A method of treating the spine as in claim 30, wherein rotation of the insertion tip is continued until the desired degree of distraction between the first vertebral body and the second vertebral body is achieved.

32. A method of treating the spine as in claim 17, wherein the removing the temporary distraction device comprises temporarily engaging an extraction tip of an extraction assembly with an internal threaded segment of the proximal piece and rotating the extraction tip.

33. A method of treating the spine as in claim 17, wherein the removing the temporary distraction device comprises temporarily engaging an extraction tip of an extraction assembly with an internal threaded segment of the distal piece and rotating the extraction tip.

34. A method of treating the spine as in claim 24, further comprising sequentially removing the proximal portion and the distal portion of the temporary distraction device from the lumen.

35. A method of treating the spine as in claim 34, wherein the lumen extends at least as far as the L5 vertebrae.

36. A method of treating the spine as in claim 35, wherein the lumen is linear.

37. A method of treating the spine as in claim 36, wherein the forming step comprises drilling.

38. A method of treating the spine as in claim 37, wherein the method additionally comprises removing at least a part of a disc from between the first and the second vertebral bodies.

39. A method of treating the spine as in claim 38, wherein the method additionally comprises removing an entire nucleus from between the first and the second vertebral bodies.