Tissue dilator and method for performing a spinal procedure

• US 7,914,530 B2
• Filed: 04/25/2006
• Issued: 03/29/2011
• Est. Priority Date: 06/13/1988
• Status: Expired due to Fees

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Michelson, Gary Karlin
• Primary Examiner(s): Brown; Michael A.
• Application Number:
  US11/410,612
• Publication Number:
  US 20060200139A1
• Time in Patent Office: 1,799 Days
• Field of Search: 606/60, 606246-248, 606/53, 623/17.1
• US Class Current: 606/52
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/1655 for tapping
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/32 Surgical cutting instruments A61B18/042 takes precedence; suture cutters A61B17/0467; instruments for ligaturing or cutting A61B17/128; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 17/8877 characterised by the cross-section of the driver bit
• CPC Class Codes: A61B 17/8888 at its central region
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/922 Devices for impaction, impact element
• CPC Class Codes: A61B 2090/036 abutting on tissue or skin
• CPC Class Codes: A61F 2/30744 End caps, e.g. for closing an endoprosthetic cavity
• 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 2/446 having a circular or elliptical cross-section substantially parallel to the axis of the spine, e.g. cylinders or frustocones
• CPC Class Codes: A61F 2/4603 for insertion or extraction of endoprosthetic joints or of accessories thereof
• CPC Class Codes: A61F 2/4611 of spinal prostheses
• CPC Class Codes: A61F 2002/2835 Bone graft implants for filling a bony defect or an endoprosthesis cavity, e.g. by synthetic material or biological material
• CPC Class Codes: A61F 2002/30143 hexagonal
• CPC Class Codes: A61F 2002/30224 cylindrical
• CPC Class Codes: A61F 2002/30235 tubular, e.g. sleeves
• CPC Class Codes: A61F 2002/30405 : made by screwing complementary threads machined on the parts themselves
• CPC Class Codes: A61F 2002/30426 : Bayonet coupling
• CPC Class Codes: A61F 2002/30593 : hollow
• CPC Class Codes: A61F 2002/30774 : internally-threaded
• CPC Class Codes: A61F 2002/30785 : parallel
• CPC Class Codes: A61F 2002/30787 : inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/30797 : internally-threaded
• CPC Class Codes: A61F 2002/30836 : knurled
• CPC Class Codes: A61F 2002/3085 : with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
• CPC Class Codes: A61F 2002/30904 : serrated profile, i.e. saw-toothed
• CPC Class Codes: A61F 2002/448 : comprising multiple adjacent spinal implants within the same intervertebral space or within the same vertebra, e.g. comprising two adjacent spinal implants
• CPC Class Codes: A61F 2002/4619 : for extraction
• CPC Class Codes: A61F 2002/4627 : with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument
• CPC Class Codes: A61F 2002/4629 : connected to the endoprosthesis or implant via a threaded connection
• CPC Class Codes: A61F 2002/4649 : Bone graft or bone dowel harvest sites
• CPC Class Codes: A61F 2002/4681 : by applying mechanical shocks, e.g. by hammering
• CPC Class Codes: A61F 2002/4687 : Mechanical guides for implantation instruments
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2230/0017 : Angular shapes
• CPC Class Codes: A61F 2230/0069 : cylindrical

Abstract

Apparatus and a method of inserting spinal implants is disclosed in which an intervertebral space is first distracted, a hollow sleeve having teeth at one end is then driven into the vertebrae adjacent that disc space. A drill is then passed through the hollow sleeve removing disc and bone in preparation for receiving the spinal implant which is then inserted through the sleeve. Apparatus and a method of inserting spinal implants is disclosed in which an intervertebral space is first distracted to restore the normal angular relationship of the vertebrae adjacent to that disc space. An extended outer sleeve having extended portions capable of maintaining the vertebrae distracted in their normal angular relationship is then driven into the vertebrae adjacent that disc space. A drill is then passed through the hollow sleeve removing disc and bone in preparation for receiving the spinal implant which is then inserted through the sleeve.

Claims

1. A method for performing a surgical procedure on a spine of a patient, comprising:

providing an apparatus having a proximal end and a distal end opposite the proximal end, a length between the proximal and distal ends, a longitudinal axis extending through the proximal and distal ends, a first portion and a second portion each having a tapered portion at the distal end, the first and second portions being spaced apart from each other, each of the tapered portions having an at least in part arcuate exterior surface spaced from the longitudinal axis, and at least in part arcuate cross sections transverse to the longitudinal axis, the at least in part arcuate cross sections progressively decreasing in area in a direction from the proximal end to the distal end, and each of the first and second portions having a length and a width perpendicular to the length, the lengths of the first and second portions being at least three times the widths of the first and second portions;

placing the apparatus into the patient to provide access to a disc of the spine adjacent the first and second portions;

inserting a first tool through the apparatus and into the spine; and

inserting a second tool through the apparatus and into the spine prior to removing the first tool.

2. The method of claim 1, further comprising excising at least part of an intervertebral disc.

3. The method of claim 1, wherein the first tool is a distractor.

4. The method of claim 3, wherein the second tool is a device for removing spinal material.

5. The method of claim 1, the apparatus further comprising a third portion having a tapered portion at the distal end, the tapered portion having an at least in part arcuate cross section transverse to the longitudinal axis, and the third portion being spaced apart from the first and second portions.

6. The method of claim 1, wherein the first and second portions are the same size and shape.

7. The method of claim 1, wherein the at least in part arcuate cross sections of the tapered portions are arcs of the same circle.

8. The method of claim 1, wherein the proximal end of the apparatus is configured to engage a mechanism designed to facilitate placing the apparatus into the patient.

9. The method of claim 1, further comprising inserting a bone graft into the spine.

10. The method of claim 1, further comprising inserting an implant into the spine.

11. The method of claim 1, wherein the apparatus is a cannula.

12. A method for performing a surgical procedure on a spine of a patient, comprising:

providing an apparatus having a proximal end and a distal end opposite the proximal end, a length between the proximal and distal ends, a longitudinal axis extending between the proximal and distal ends, a first portion and a second portion each having a tapered portion at the distal end, the first and second portions being spaced apart from each other, each of the tapered portions having an at least in part arcuate exterior surface spaced from the longitudinal axis, and at least in part arcuate cross sections transverse to the longitudinal axis, the at least in part arcuate cross sections progressively decreasing in area in a direction from the proximal end to the distal end, and each of the first and second portions having a length and a width perpendicular to the length, the lengths of the first and second portions being at least three times the widths of the first and second portions;

creating a surgical corridor in the patient providing access to a disc of the spine, the surgical corridor having a cross sectional perimeter transverse to the longitudinal axis, at least a portion of the cross sectional perimeter of the surgical corridor being formed by an interior surface of the first and second portions;

accessing the disc through the surgical corridor;

inserting a first implement into the surgical corridor and into the spine; and

inserting a second implement into the surgical corridor and into the spine coincident to the first implement.

13. The method of claim 12, further comprising excising at least part of an intervertebral disc.

14. The method of claim 12, wherein the first implement is a distractor.

15. The method of claim 14, wherein the second implement is a device for removing spinal material.

16. The method of claim 12, the apparatus further comprising a third portion having a tapered portion at the distal end, the tapered portion having an at least in part arcuate cross section transverse to the longitudinal axis, and the third portion being spaced apart from the first and second portions.

17. The method of claim 12, wherein the first and second portions are the same size and shape.

18. The method of claim 12, wherein the at least in part arcuate cross sections of the tapered portions are arcs of the same circle.

19. The method of claim 12, wherein the proximal end of the apparatus is configured to engage a mechanism designed to facilitate placing the apparatus into the patient.

20. The method of claim 12, further comprising inserting an implant into the spine.

21. The method of claim 12, wherein the apparatus is a cannula.