Nerve surveillance cannulae systems

• US 7,693,562 B2
• Filed: 10/31/2007
• Issued: 04/06/2010
• Est. Priority Date: 12/23/1998
• Status: Expired due to Fees

• Current Assignee: Nuvasive Incorporated
• Original Assignee: Nuvasive Incorporated
• Inventors: Marino, James F., Stone, Corbett W., Christopher, Troy K., Blewett, Jeffrey J., Kelleher, Brian S.
• Primary Examiner(s): Peffley; Michael
• Assistant Examiner(s): Hupczey, Jr.; Ronald J
• Application Number:
  US11/982,250
• Publication Number:
  US 20080064945A1
• Time in Patent Office: 888 Days
• Field of Search: 600/372, 600/373, 128/898, 607115-118, 606/1, 606 32- 52, 606191-192, 606/213, 604/20, 604/21, 604/27, 604/500, 604/912
• US Class Current: 600/373
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 17/3439 with means for changing the inner diameter of the cannula, e.g. expandable A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662
• CPC Class Codes: A61B 18/148 having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
• CPC Class Codes: A61B 18/1487 Trocar-like, i.e. devices producing an enlarged transcutaneous opening
• CPC Class Codes: A61B 2017/3484 Anchoring means, e.g. spreading-out umbrella-like structure
• CPC Class Codes: A61B 2018/00589 Coagulation
• CPC Class Codes: A61B 2018/00595 Cauterization
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/296 for electromyography [EMG]
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/4029 for evaluating the peripheral nervous systems A61B5/24 takes precedence
• CPC Class Codes: A61B 5/4041 Evaluating nerves condition
• CPC Class Codes: A61B 5/4893 Nerves
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes

Abstract

An expandable tip cannula system, comprising: a hollow cannula shaft having a proximal end and a distal end; and an expandable tip mounted at the distal end of the hollow cannula shaft, the expandable tip comprising a plurality of generally-triangular shaped petals held together in a radially-inwardly tapered arrangement between adjacent petals, each petal comprising a nerve sensing electrode disposed therein.

Claims

1. A method of accessing a surgical target site, comprising:

providing a surgical access instrument having a proximal portion and a distal portion, said distal portion having at least one nerve stimulation electrode located thereon, said distal portion being expandable from a first initial position;

advancing said distal portion of said surgical access instrument toward a surgical target site while said distal portion is in said first position and while energizing said at least one nerve stimulation electrode in an amount sufficient to depolarize nerves adjacent said distal portion such that said nerves may be detected and avoided; and

expanding said distal portion from said first position to a second position to create an operative corridor to said surgical target site.

2. The method of claim 1, wherein said surgical access instrument comprises a cannula.

3. The method of claim 1, wherein said surgical access instrument is configured to allow passage of a surgical implant through said operative corridor to said surgical target site.

4. The method of claim 1, wherein said distal portion includes a plurality of tissue displacement members.

15. The method of claim 4, wherein said tissue displacement members engage each other in said first position.

16. The method of claim 15, wherein said tissue displacement members are separated by gaps in said second position.

17. The method of claim 16, wherein said surgical access instrument includes an expandable member situated on said distal portion.

18. The method of claim 17, wherein said expandable member covers said gaps in said second position.

19. The method of claim 17, wherein said expandable member is an elastomer encasing said tissue displacement members.

5. A method of performing spine surgery, comprising:

providing a surgical access instrument configured to provide access to a spinal target site, said surgical access instrument having a proximal portion and a distal portion, said distal portion having at least one nerve stimulation electrode located thereon, said distal portion being expandable from a first initial position;

advancing said distal portion of said surgical access instrument toward said spinal target site while energizing said at least one nerve stimulation electrode in an amount sufficient to depolarize nerves adjacent said distal portion such that said nerves may be detected and avoided; and

expanding said distal portion from said first position to a second position to create an access corridor to said spinal target site; and

introducing a spinal implant into said spinal target site by advancing said spinal implant along said access corridor.

6. The method of claim 5, wherein said surgical access instrument comprises a cannula.

7. The method of claim 5, wherein said distal portion includes a plurality of tissue displacement members.

8. The method of claim 5, wherein said spinal target site comprises an intervertebral space.

9. The method of claim 5, wherein said spinal implant comprises an intervertebral implant.

10. The method of claim 7, wherein said tissue displacement members engage each other in said first position.

11. The method of claim 7, wherein said tissue displacement members are separated by gaps in said second position.

12. The method of claim 11, wherein said surgical access instrument includes an expandable member situated on said distal portion.

13. The method of claim 12, wherein said expandable member covers said gaps in said second position.

14. The method of claim 11, wherein said expandable member is an elastomer encasing said tissue displacement members.