Method for using a guard for creating a socket posteriorly in the lumbar spine

• US 8,764,755 B2
• Filed: 06/07/2011
• Issued: 07/01/2014
• Est. Priority Date: 03/01/2001
• Status: Expired due to Term

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Michelson, Gary K.
• Primary Examiner(s): Ramana, Anu
• Assistant Examiner(s): ARAJ, MICHAEL J
• Application Number:
  US13/155,289
• Publication Number:
  US 20110257746A1
• Time in Patent Office: 1,120 Days
• Field of Search: 606/79, 606/80, 606/84, 606/85, 606/86.A, 623 1711- 1716
• US Class Current: 606/86.A
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/14 Surgical saws A61B17/1637 takes precedence; tooth saws A61C3/12 ; Accessories therefor
• CPC Class Codes: A61B 17/147 with circularly moving saw blades, i.e. non-reciprocating saw blades
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/16 Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans arthroscopic bone cutters A61B17/320016; dental implant drills potentially for other surgical use A61C8/0089; bone grinders A61F2/4644, A22C17/06; A61B17/1662 takes precedence over all other subgroups except A61B17/17
• 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 17/17 Guides or aligning means for drills , mills, pins or wires
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/56 Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
• CPC Class Codes: A61B 17/88 Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices A61B17/7074 takes precedence
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/320004 abrasive
• CPC Class Codes: A61B 2017/564 Methods for bone or joint treatment
• CPC Class Codes: A61F 2/44 for the spine, e.g. vertebrae, spinal discs
• 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 2/4455 for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages intervertebral discs A61F2/442
• CPC Class Codes: A61F 2/447 : substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section
• CPC Class Codes: A61F 2/4611 : of spinal prostheses
• CPC Class Codes: A61F 2002/30187 : D-shaped or half-disc-shaped
• CPC Class Codes: A61F 2002/30224 : cylindrical
• CPC Class Codes: A61F 2002/30593 : hollow
• CPC Class Codes: A61F 2002/30624 : Hinged joint, e.g. with transverse axle restricting the movement
• CPC Class Codes: A61F 2002/30729 : Separate collars
• CPC Class Codes: A61F 2002/30785 : parallel
• CPC Class Codes: A61F 2002/30787 : inclined obliquely with respect to each other
• CPC Class Codes: A61F 2002/30975 : made of two halves
• CPC Class Codes: A61F 2002/4622 : having the shape of a forceps or a clamp
• 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 2002/4628 : with linear motion along or rotating motion about an axis transverse to the instrument axis or to the implantation direction, e.g. clamping
• CPC Class Codes: A61F 2230/0034 : D-shaped
• CPC Class Codes: A61F 2230/0069 : cylindrical

Abstract

A method for guiding a bone removal device to form a socket in the human spine and for inserting a cortical bone implant into the socket. The method includes placing a guard against the posterior aspect of the spine, the guard having a passage therethrough, inserting the bone removal device into the passage, removing a portion of a facet joint with the bone removal device to create the socket having a maximum height, and inserting the cortical bone implant into the socket. The cortical bone implant has a leading end, a trailing end, a mid-longitudinal axis through the ends, and a height transverse to the mid-longitudinal axis, the height of the cortical bone implant being greater than the maximum height of the socket.

Claims

1. A method for inserting a cortical bone implant into a posterior aspect of the human spine, comprising:

placing a guard against the posterior aspect of the spine, the guard having a passage therethrough;

inserting a bone removal device into the passage of the guard, the bone removal device having a cutting portion including a leading end, a trailing end, and a central longitudinal axis through the leading and trailing ends;

removing a portion of a facet joint with the bone removal device to create a socket having a maximum height; and

inserting a cortical bone implant into the socket created by the bone removal device, the cortical bone implant having a leading end, a trailing end, a mid-longitudinal axis through the ends, and a height transverse to the mid-longitudinal axis, the height of the cortical bone implant being greater than the maximum height of the socket.

2. The method of claim 1, wherein the bone removal device inserted into the passage of the guard is configured to rotate the cutting portion to remove the portion of the facet joint.

3. The method of claim 2, wherein bone removal device is a drill.

4. The method of claim 1, further comprising applying an impaction force against a trailing end of the guard to stabilize the guard relative to the posterior aspect of the spine.

5. The method of claim 1, further comprising monitoring the depth of insertion of the bone removal device with a radiographic imaging device.

6. The method of claim 1, further comprising irrigating inside and outside the guard.

7. The method of claim 1, wherein the cortical bone implant inserted through the passage of the guard has a circular cross section.

8. The method of claim 1, wherein the guard has a rectangular cross section.

9. The method of claim 1, wherein a portion of the socket is formed in an endplate of a vertebral body with the bone removal device.

10. The method of claim 1, wherein the guard includes two extensions at a leading end thereof for insertion at least in part between two adjacent vertebral bodies.

11. The method of claim 1, wherein the guard includes an upper portion and a lower portion, the upper and lower portions being pivotally attached to one another.

12. A method for inserting a cortical bone implant into a posterior aspect of the human spine, comprising:

placing a guard against the posterior aspect of the spine, the guard having a passage therethrough;

forming a socket through a portion of a facet joint using an instrument inserted through the passage of the guard, including compacting portions of bone forming the socket to increase the density of the bone forming the socket, the socket having a maximum height; and

inserting a cortical bone implant into the socket, the cortical bone implant having a leading end, a trailing end, a mid-longitudinal axis through the ends, and a height transverse to the mid-longitudinal axis, the height of the cortical bone implant being greater than the maximum height of the socket.

13. The method of claim 12, wherein the socket is formed at least in part with a bone removal device inserted into the passage of the guard, the bone removal device having a rotatable cutting portion.

14. The method of claim 13, wherein bone removal device is a drill.

15. The method of claim 13, wherein a portion of the socket is formed in an endplate of a vertebral body with the bone removal device.

16. The method of claim 12, further comprising applying an impaction force against a trailing end of the guard to stabilize the guard relative to the posterior aspect of the spine.

17. The method of claim 12, further comprising monitoring the depth of insertion of the bone removal device with a radiographic imaging device.

18. The method of claim 12, further comprising irrigating inside and outside the guard.

19. The method of claim 12, wherein the cortical bone implant inserted through the passage of the guard has a circular cross section.

20. The method of claim 12, wherein the guard has a rectangular cross section.

21. The method of claim 12, wherein the guard includes two extensions at a leading end thereof for insertion at least in part between two adjacent vertebral bodies.

22. The method of claim 12, wherein the guard includes an upper portion and a lower portion, the upper and lower portions being pivotally attached to one another.