Transpedicular intervertebral disk access methods and devices

• US 7,641,658 B2
• Filed: 06/25/2003
• Issued: 01/05/2010
• Est. Priority Date: 11/08/2002
• Status: Active Grant

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Divino, Vincent Jr., Shaolian, Samuel M., Henson, Michael R., Teitelbaum, George P.
• Primary Examiner(s): Robert; Eduardo C
• Assistant Examiner(s): Hoffman; Mary
• Application Number:
  US10/607,478
• Publication Number:
  US 20040106940A1
• Time in Patent Office: 2,386 Days
• Field of Search: 606/79, 606/80, 606/167, 606/170, 606/180
• US Class Current: 606/80
• CPC Class Codes: A61B 17/1617 with mobile or detachable parts
• CPC Class Codes: A61B 17/1642 for producing a curved bore
• CPC Class Codes: A61B 17/1675 for the knee
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/7097 Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants disc prostheses made of inflatable chambers or pockets filled with fluid A61F2/441; replacing the nucleus pulposus A61F2002/444
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/564 Methods for bone or joint treatment
• 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 2002/444 for replacing the nucleus pulposus

Abstract

Methods and devices for treating diseases and conditions that change the spacial relationship between the vertebral bodies and the intervertebral disks, or that cause instability of the vertebral column, or both, and a method and devices that allow the surgeon to access the intervertebral space to restore a more normal three-dimensional configuration of the space, with or without additionally fusing two adjacent vertebrae.

Claims

1. A cutting device comprising:

a blade pivotally connected to the distal end of a flexible shaft;

a locking sleeve surrounding at least part of the flexible shaft;

a sheath having a beveled distal end and surrounding at least part of the flexible shaft;

where the cutting device can be inserted into a material to be cut after accessing the material through a channel comprising a substantially straight proximal section having a long axis and distal section having a long axis;

and where the long axis of the distal section is curved, or where the long axis of the distal section is substantially straight but varies at least about 10°

off of the long axis of the proximal section;

where the blade pivots at least about 90°

with respect to a long axis of the distal end of the flexible shaft from a first, insertion position to a second, cutting position;

where the blade has one or more than one notch;

where the locking sleeve can be advanced distally and retracted proximally;

where advancement distally causes the locking sleeve to engage with the one or more than one notch, thereby locking the blade into the cutting position, and retraction proximally causes the locking sleeve to disengage from the one or more than one notch, thereby unlocking the blade from the cutting position;

where the flexible shaft can be advanced distally and retracted proximally relative to the sheath; and

where retraction proximally of the flexible shaft causes the blade to disengage from the locking sleeve and pivot to the insertion position.

2. A cutting device comprising:

a flexible shaft having a proximal end and a distal end;

a locking sleeve slidable on the flexible shaft between a first position and a second position; and

a blade pivotally connected to the flexible shaft and movable from a first, insertion position to a second, cuffing position substantially orthogonal with respect to a long axis of the distal end of the flexible shaft;

the blade comprising at least one notch for engaging a distal end of the locking sleeve to lock the blade in the cuffing position when the locking sleeve is in the second position.

3. The cuffing device of claim 2, further comprising:

a hinge that pivotally connects the blade to the flexible shaft.

4. The cuffing device of claim 2, where the blade pivots from the insertion position to the cuffing position.

5. The cuffing device of claim 2, wherein the cuffing device can be inserted into a material to be cut after accessing the material through a channel comprising a substantially straight proximal section having a long axis and a distal section having a long axis;

and

where the long axis of the distal section is curved, or where the long axis of the distal section is substantially straight but varies at least about 10°

off of the long axis of the proximal section.

6. The cutting device of claim 2, wherein the blade comprises a circumferential cuffing surface.

7. The cuffing device of claim 2, further comprising a knob for moving the locking sleeve between the first position and the second position.

8. The cuffing device of claim 2, further comprising:

a sheath having a beveled distal end and surrounding at least part of the flexible shaft;

where the flexible shaft can be advanced distally and retracted proximally relative to the sheath; and

where retraction proximally of the flexible shaft causes the blade to disengage from the locking sheath and pivot to the insertion position.

9. The cuffing device of claim 2, further comprising:

a proximal end comprising a motor adaptor for connecting the cuffing device to a motor drive; and

a distal end, where the blade is attached.

10. A method of cutting a material comprising:

a) providing the cutting device of claim 2

b) inserting the cuffing device into the material after accessing the material through a channel comprising a substantially straight proximal section having a long axis and a distal section having a long axis; and

c) actuating the cuffing device;

where the long axis of the distal section is curved, or where the long axis of the distal section is substantially straight but varies at least about 10°

off of the long axis of the proximal section.

11. The method of claim 10, further comprising:

advancing and retracting the cuffing device within the material.

12. The method of claim 10, further comprising:

inserting a sheath into the channel before inserting the cutting device, and inserting the cutting device through the sheath.