Surgical instrumentation and method for treatment of a spinal structure

• US 8,034,088 B2
• Filed: 01/20/2006
• Issued: 10/11/2011
• Est. Priority Date: 02/12/2004
• Status: Active Grant

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Pagano, Paul J.
• Primary Examiner(s): RAMANA, ANURADHA
• Application Number:
  US11/336,123
• Publication Number:
  US 20060116690A1
• Time in Patent Office: 2,090 Days
• Field of Search: 606 92- 94
• US Class Current: 606/279
• CPC Class Codes: A61B 17/025 Joint distractors
• 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 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 17/3472 for bones, e.g. intraosseus injections
• CPC Class Codes: A61B 17/8811 characterised by the introducer tip, i.e. the part inserted into or onto the bone
• CPC Class Codes: A61B 17/8858 laterally or radially expansible inflatable A61B17/8855
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2090/034 abutting on parts of the device itself
• CPC Class Codes: A61B 2090/0801 Prevention of accidental cutting or pricking

Abstract

Instrumentation and method for treatment of a spinal structure, comprising an elongate member including a deformable distal portion having an initial configuration for placement within the spinal structure and a deformed configuration wherein the distal portion is outwardly deformed to form a cavity in the spinal structure. The elongate member comprises a cannula member and an actuator member that is removably positioned within the cannula member and configured to transition the deformable distal portion from the initial configuration toward the deformed configuration. The actuator member is selectively removed from the cannula member to provide a passageway for delivery of a material into the cavity formed in the spinal structure.

Claims

1. A method for treatment of the spine, comprising:

providing an instrument defining a cannula passage extending along a longitudinal axis and including a deformable distal portion having an insertion configuration and a deformed configuration, the instrument having a closed distal end and a sidewall opening proximal to the closed distal end and in communication with the cannula passage;

positioning the distal portion of the instrument within a spinal structure while in the insertion configuration;

transitioning the distal portion of the instrument toward the deformed configuration through the sidewall opening and in response to a mechanically induced force and forming a cavity within the spinal structure; and

delivering a material through the cannula passage and into the cavity in the spinal structure.

2. The method of claim 1, wherein the transitioning of the distal portion of the instrument toward the deformed configuration is uniaxial along an axis transverse to the longitudinal axis.

3. The method of claim 1, wherein the transitioning of the distal portion of the instrument toward the deformed configuration is unidirectional along the transverse axis.

4. The method of claim 1, wherein the transitioning comprises mechanically deforming the distal portion of the instrument to form at least one transverse projection for forming the cavity within the spinal structure.

5. The method of claim 4, wherein the at least one transverse projection is arranged along an axis transverse to the longitudinal axis such that the transitioning of the distal portion of the instrument toward the deformed configuration is axially controlled along the transverse axis.

6. The method of claim 4, wherein the deformed configuration of the distal portion of the instrument defines a single transverse projection such that the transitioning of the distal portion of the instrument toward the deformed configuration is directionally controlled along the transverse axis.

7. The method of claim 4, wherein the transitioning of the distal portion toward the deformed configuration comprises selectively controlling the deforming to generate a controlled magnitude of force against the spinal structure.

8. The method of claim 1, wherein the instrument comprises:

a cannula member defining the cannula passage and defining a transverse opening communicating with the cannula passage; and

an actuator member positioned within the cannula passage and including a deformable element disposed adjacent the transverse opening; and

wherein the transitioning comprises outwardly deforming the deformable element to form a transverse projection extending through the transverse opening in the cannula member.

9. The method of claim 8, wherein the outwardly deforming of the deformable element comprises outward buckling.

10. The method of claim 9, wherein the deformable element of the actuator member comprises a thin strip of material to facilitate the outward buckling.

11. The method of claim 9, wherein the outward buckling of the deformable element results from relative linear displacement between the actuator member and the cannula member.

12. The method of claim 1, wherein the instrument comprises a cannula member defining the cannula passage and an actuator member removably positioned within the cannula passage and configured to provide the transitioning of the distal portion of the instrument from the insertion configuration toward the deformed configuration;

and

wherein the method further comprises selectively removing the actuator member from the cannula member to allow for the delivering of the material through the cannula passage and into the cavity.

13. The method of claim 1, wherein the transitioning occurs in response to the imposition of a mechanically induced force.

14. The method of claim 13, wherein the instrument comprises a first member and a second member engaged with the first member;

and

wherein the transitioning occurs in response to relative displacement between the first member and the second member to outwardly deform at least a portion of the second member to form at least one transverse projection.

15. The method of claim 14, wherein the relative displacement comprises relative linear displacement between the first member and the second member.

16. The method of claim 14, wherein the relative displacement between the first member and the second member is regulated to control the outward deformation of the at least a portion of the second member and to generate a controlled magnitude of force against the spinal structure.

17. The method of claim 1, wherein the instrument includes a retaining element for selectively preventing the transitioning of the distal portion of the instrument from the insertion configuration toward the deformed configuration.

18. The method of claim 17, further comprising disengaging the retaining element from the instrument subsequent to the positioning to allow for the transitioning of the distal portion of the instrument from the insertion configuration toward the deformed configuration.

19. The method of claim 1, wherein the positioning comprises inserting the distal portion of the instrument into a vertebral body;

and

wherein the transitioning of the distal portion of the instrument toward the deformed configuration results in compacting cancellous bone to form the cavity within the vertebral body.

20. The method of claim 1, wherein the positioning comprises inserting the distal portion of the instrument into a vertebral body;

and

wherein the transitioning of the distal portion of the instrument toward the deformed configuration results in at least partially reducing a compression fracture to form the cavity within the vertebral body.

21. The method of claim 1, wherein the positioning comprises inserting the distal portion of the instrument into an intervertebral disc space between adjacent vertebral bodies;

and

wherein the transitioning of the distal portion of the instrument toward the deformed configuration exerts a force onto the adjacent vertebral bodies to distract the intervertebral disc space.

22. The method of claim 1, wherein the instrument includes a trocar tip;

and

wherein the positioning comprises introducing the trocar tip into the spinal structure to facilitate insertion of the deformable distal portion of the instrument into the spinal structure.

23. The method of claim 22, wherein the positioning is accomplished by imparting an impaction force onto the instrument to facilitate insertion of the deformable distal portion into the spinal structure.

24. The method of claim 23, wherein the flowable material comprises a bone cement capable of setting to a hardened condition subsequent to the delivering.

25. The method of claim 1, wherein the material comprises a flowable material.

26. The method of claim 25, wherein the instrument includes a connector portion defining a passageway in communication with the cannula passage;

and

wherein the delivering comprises coupling a material delivery system to the connector portion and injecting the material through the cannula passage and into the cavity in the spinal structure.