Methods for distraction of a disc space

• US 20040236331A1
• Filed: 07/01/2004
• Published: 11/25/2004
• Est. Priority Date: 06/13/1988
• Status: Active Grant

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Michelson, Gary Karlin
• Granted Patent: US 7,686,805 B2
• Time in Patent Office: Days
• US Class Current: 606/61
• 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 of maintaining distraction of a spinal disc space, the method comprising:

exposing a portion of the spine at the disc space;

distracting the disc space to a desired height with a disc distractor;

selecting first and second shims each having a shaft connected to a blade, the blade having a height between a top surface and a bottom surface that corresponds to the distracted disc space height, the blade, further having a length extending between a leading end and a trailing end, and a thickness extending between a first side surface and a second side surface;

inserting the first shim into the disc space with one of the side surfaces adjacent one side of the disc distractor;

inserting the second shim into the disc space with one of the side surfaces adjacent the other side of the disc distractor;

removing the disc distractor from the disc space; and

performing subsequent procedures in the disc space.

2. The method according to claim 1, wherein selecting a shim further comprises selecting the shim with the blade length sized to correspond to the depth of the disc space.

3. The method according to claim 1, wherein the blade height to width ratio of the selected shims is greater than about 3.

4. A tissue dilator, comprising:

a sleeve having a tapered working end and an opposite end, said working end configured to displace tissue; and

a gripping portion on an outer surface of said sleeve adjacent said opposite end, said gripping portion defining a plurality of circumferential grooves configured for manually gripping the dilator to manipulate the dilator within tissue.

5. A method for performing a surgical procedure al a location on the spine, comprising:

inserting a cannula into a patient through skin and tissue to create a working channel;

creating a working space in communication with the working channel and adjacent the location on the spine;

removably inserting a first tool through the working channel;

manipulating the first tool to perform a function at the location;

removably inserting a second tool through the working channel simultaneous with the first tool; and

manipulating the second tool to perform a function at the location.

6. A surgical instrument for distracting a spinal disc space, comprising:

a distractor having a length and including;

a shaft and a first distractor tip connected to an en;

;

of said shaft, including;

a first surface and an opposite second surface defining a distraction height; and

a recessed area extending between said first and second surfaces along at least a portion of said length.

7. The instrument of claim 6, wherein said first surface and said second surface are substantially parallel.

8. The instrument of claim 7, wherein said first surface and said second surface are each substantially planar.

9. The instrument of claim 6, wherein said recessed area is configured to permit rotation of a surgical device positioned adjacent thereto.

10. The instrument of claim 6, wherein said distractor tip is integrally formed with said shaft.

11. The instrument of claim 6, wherein said recessed area is a concave surface extending between said first and second surfaces.

12. The instrument of claim 11, wherein said distractor tip includes a convex surface opposite said concave surface extending between said first and second surfaces.

13. The instrument of claim 6, wherein said distractor tip includes a rounded leading end extending between said first and second surfaces.