Instrumentation and method for performing image-guided spinal surgery using an anterior surgical approach

• US 6,980,849 B2
• Filed: 07/08/2003
• Issued: 12/27/2005
• Est. Priority Date: 04/17/2002
• Status: Active Grant

• Current Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Original Assignee: Warsaw Orthopedic Incorporated (Medtronic Plc)
• Inventors: Sasso, Ricardo
• Primary Examiner(s): Imam, Ali
• Assistant Examiner(s): JUNG, WILLIAM C
• Application Number:
  US10/615,227
• Publication Number:
  US 20040092928A1
• Time in Patent Office: 903 Days
• Field of Search: 600/407, 600/414, 600/420, 600/423, 600/424, 600/426, 600/434, 606/14, 606/27, 606/30, 606 60- 62, 606/74, 606/150, 606/130, 604/164.01, 604/164.11, 378/20, 378/42
• US Class Current: 600/426
• CPC Class Codes: A61B 17/1757 for the spine
• CPC Class Codes: A61B 17/863 with thread interrupted or changing its form along shank, other than constant taper
• CPC Class Codes: A61B 2090/034 abutting on parts of the device itself
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 2090/3987 Applicators for implanting markers
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

Instrumentation and methods are provided for performing image-guided spinal surgery using an anterior surgical approach. In one embodiment, the method comprises providing a surgical navigation reference device, mounting the reference device to bone at a location remote from the spinal column and in a substantially fixed position relative thereto, accessing a portion of the spinal column from an anterior direction, and performing an image-guided surgical procedure on the spinal column using an anterior surgical approach. In another embodiment, the mounting of the reference device comprises anchoring the reference device to a portion of the patient'"'"'s pelvic bone, and more specifically the anterior region of the iliac crest. In a further embodiment, the image-guided surgical procedure comprises a spinal implantation procedure wherein a spinal implant is inserted into an intervertebral opening formed along the lumbar region of the spinal column using an anterior surgical approach.

Claims

1. A method for performing image-guided spinal surgery on a patient, comprising:

providing a surgical navigation reference device;

mounting the reference device to bone at a location remote from the patient'"'"'s spinal column and in a substantially fixed position relative thereto;

accessing a portion of the spinal column from an anterior direction; and

performing an image-guided surgical procedure on the spinal column using an anterior surgical approach.

2. The method of claim 1, wherein the mounting comprises anchoring the reference device to a portion of the patient'"'"'s pelvic bone.

3. The method of claim 2, wherein the portion of the patient'"'"'s pelvic bone comprises the iliac region of the pelvic bone.

4. The method of claim 3, wherein the portion of the patient'"'"'s pelvic bone comprises the iliac crest.

5. The method of claim 4, wherein the portion of the pelvic bone is an anterior region of the iliac crest.

6. The method of claim 5, wherein the portion of the patient'"'"'s pelvic bone comprises an anterior-superior region of the iliac crest.

7. The method of claim 1, further comprising providing a bone anchor;

and

wherein the mounting comprises anchoring the bone anchor to the bone and coupling the reference device to the bone anchor; and

wherein the accessing occurs subsequent to the anchoring.

8. The method of claim 7, wherein the anchoring comprises anchoring the bone anchor to a portion of the patient'"'"'s pelvic bone.

9. The method of claim 8, wherein the portion of the patient'"'"'s pelvic bone comprises an anterior region of the iliac crest.

10. The method of claim 7, wherein the anchoring comprises percutaneously inserting the bone anchor into the patient.

11. The method of claim 10, wherein the percutaneously inserting comprises:

providing a cannula having a proximal end and a distal end;

providing a trocar having a distal end portion;

positioning the trocar within the cannula with the distal end portion of the trocar extending beyond the distal end of the cannula;

percutaneously introducing the cannula into the patient;

removing the trocar from the cannula; and

inserting the bone anchor through the cannula and into engagement with the bone.

12. The method of claim 1, wherein the accessing comprises forming a surgical incision remote from the mounting location;

and

wherein the performing of the image-guided surgical procedure is accomplished through the surgical incision.

13. The method of claim 12, wherein the surgical incision is formed subsequent to the mounting.

14. The method of claim 1, wherein the performing of the image-guided surgical procedure is accomplished percutaneously.

15. The method of claim 1, wherein the image-guided surgical procedure comprises an artificial disc replacement procedure.

16. The method of claim 15, wherein the artificial disc replacement procedure is performed along the lumbar region of the spinal column.

17. The method of claim 1, wherein the performing of the image-guided surgical procedure comprises:

providing a spinal implant;

removing a portion of a natural intervertebral disc to form an intervertebral opening; and

inserting the spinal implant into the intervertebral opening using an anterior surgical approach.

18. The method of claim 17, wherein the spinal implant comprises an artificial intervertebral disc.

19. A method for performing image-guided spinal surgery on a patient, comprising:

providing a surgical navigation reference device and a spinal implant;

mounting the reference device to bone at a location remote from the patient'"'"'s spinal column and in a substantially fixed position relative thereto;

accessing a portion of the spinal column from an anterior direction; and

performing an image-guided surgical procedure on the spinal column using an anterior surgical approach, including removing a portion of a natural intervertebral disc to form an intervertebral opening and inserting the spinal implant into the intervertebral opening.

20. The method of claim 19, wherein the mounting comprises anchoring the reference device to a portion of the patient'"'"'s pelvic bone.

21. The method of claim 20, wherein the portion of the patient'"'"'s pelvic bone comprises the iliac region of the pelvic bone.

22. The method of claim 21, wherein the portion of the patient'"'"'s pelvic bone comprises the iliac crest.

23. The method of claim 22, wherein the portion of the patient'"'"'s pelvic bone comprises an anterior region of the iliac crest.

24. The method of claim 19, further comprising providing a bone anchor;

and

wherein the mounting comprises anchoring the bone anchor to the bone and coupling the reference device to the bone anchor; and

wherein the accessing occurs subsequent to the anchoring.

25. The method of claim 24, wherein the anchoring comprises percutaneously inserting the bone anchor into the patient.

26. The method of claim 19, wherein the accessing comprises forming a surgical incision remote from the mounting location;

and

wherein the performing of the image-guided surgical procedure is accomplished through the surgical incision.

27. The method of claim 26, wherein the surgical incision is formed subsequent to the mounting.

28. The method of claim 19, wherein the image-guided surgical procedure is performed along the lumbar region of the spinal column.

29. The method of claim 19, wherein the spinal implant comprises an artificial intervertebral disc.

30. A method for performing image-guided spinal surgery on a patient, comprising:

providing a surgical navigation reference device, a bone anchor, and a spinal implant;

anchoring the bone anchor to an anterior portion of the iliac region of the patient'"'"'s pelvic bone;

coupling the reference device to the bone anchor to mount the reference device in a substantially fixed position relative to the spinal column;

forming a surgical incision adjacent the lumbar region of the spinal column from an anterior direction; and

performing an image-guided surgical procedure on the lumbar region of the spinal column through the surgical incision using an anterior surgical approach, the image-guided surgical procedure including removing a portion of a natural intervertebral disc to form an intervertebral opening and inserting the spinal implant into the intervertebral opening.

31. The method of claim 30, wherein the anterior portion of the iliac region of the patient'"'"'s pelvic bone comprises the iliac crest.

32. The method of claim 30, wherein the anchoring comprises percutaneously inserting the bone anchor into the patient.

33. The method of claim 30, wherein the forming of the surgical incision occurs subsequent to the anchoring of the bone anchor.

34. The method of claim 30, wherein the performing of the image-guided surgical procedure is accomplished percutaneously.

35. The method of claim 30, wherein the spinal implant comprises an artificial intervertebral disc.