Multiple pathways for spinal nerve root decompression from a single access point

• US 9,492,151 B2
• Filed: 08/03/2015
• Issued: 11/15/2016
• Est. Priority Date: 10/15/2005
• Status: Active Grant

• Current Assignee: Spinal Elements, Inc.
• Original Assignee: Amendia, Inc. (Spinal Elements, Inc.)
• Inventors: Bleich, Jeffery L., Sheinberg, Michael, Wallace, Michael P.
• Primary Examiner(s): BATES, DAVID W
• Application Number:
  US14/816,813
• Publication Number:
  US 20150342591A1
• Time in Patent Office: 470 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/025 Joint distractors
• CPC Class Codes: A61B 17/1671 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 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 17/320758 with a rotating cutting instrument, e.g. motor driven A61B17/320725, A61B17/32075 and A61B17/320783 take precedence; for removing intra-ocular material A61F9/00763; endoscopic rotatable cutting instruments A61B17/32002
• CPC Class Codes: A61B 17/3401 Puncturing needles for the peridural or subarachnoid space or the plexus, e.g. for anaesthesia local anaesthesia A61M19/00
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3496 Protecting sleeves or inner probes; Retractable tips for protecting body piercing guide needles A61M25/0612
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/1487 Trocar-like, i.e. devices producing an enlarged transcutaneous opening
• CPC Class Codes: A61B 2017/00261 Discectomy
• CPC Class Codes: A61B 2017/00287 Bags for minimally invasive surgery
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/0225 flexible, e.g. fabrics, meshes, or membranes
• CPC Class Codes: A61B 2017/0256 for the spine
• CPC Class Codes: A61B 2017/320004 : abrasive
• CPC Class Codes: A61B 2017/320044 : Blunt dissectors blunt suture needles A61B2017/06085
• CPC Class Codes: A61B 2017/32006 : with a cutting strip, band or chain, e.g. like a chainsaw
• CPC Class Codes: A61B 2018/1407 : Loop
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 2090/061 : for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/08021 : of the patient or his organs
• CPC Class Codes: A61B 90/04 : Protection of tissue around surgical sites against effects of non-mechanical surgery, e.g. laser surgery protection of eyes against laser radiation A61F9/022
• CPC Class Codes: A61N 1/0551 : Spinal or peripheral nerve electrodes

Abstract

A method of accessing target tissue adjacent to a spinal nerve of a patient includes the steps of accessing a spine location of the patient by entering the patient through the skin at an access location, inserting a flexible tissue modification device through the access location to the spine location, advancing a distal portion of the first flexible tissue modification device from the spine location to a first exit location, passing through the first exit location and out of the patient, advancing the first or a second flexible tissue modification device through the same access location to the spine location and to a second exit location, and passing through the second exit location and out of the patient.

Claims

1. A method of accessing target tissue of a patient, the patient having a first vertebra, a second vertebra having a pedicle, an interlaminar window defined by the first vertebra and the second vertebra, a cephalad intervertebral foramen cephalad to the pedicle and defined by the first vertebra and the second vertebra, and a caudal intervertebral foramen caudal to the pedicle and defined by the second vertebra and a third vertebra, the method comprising:

accessing a spine location of the patient by entering the patient through an access location, wherein the spine location is anterior to the posterior aspect of the ligamentum flavum and posterior to the dura mater of the spinal cord and cauda equina, and the access location is lateral to the spinous process;

inserting a first flexible device through the access location, through the interlaminar window, and to the spine location;

advancing the distal portion of the first flexible device from the spine location, laterally through the cephalad intervertebral foramen;

passing the distal portion of the first flexible device through the cephalad intervertebral foramen and out of the patient;

inserting the first or a second flexible device through the same access location, through the interlaminar window, and to the spine location;

advancing the distal portion of the first or the second flexible device from the spine location, and laterally through the caudal intervertebral foramen; and

passing through the caudal intervertebral foramen and out of the patient.

2. A method of accessing target tissue to a spinal nerve of a patient, the patient having a first vertebra, a second vertebra having a left pedicle and a right pedicle, an interlaminar window defined by the first vertebra and the second vertebra, a left intervertebral foramen adjacent to the left pedicle, and a right intervertebral foramen adjacent to the right pedicle, each intervertebral foramen defined by the first vertebra and the second vertebra, the method comprising:

accessing a spine location of the patient by entering the patient through an access location, wherein the spine location is anterior to the posterior aspect of the ligamentum flavum and posterior to the dura mater of the spinal cord and cauda equina, and the access location is lateral to the spinous process;

inserting a first flexible device through the access location, through the interlaminar window, and to the spine location;

advancing the first flexible device from the spine location, laterally through the left intervertebral foramen;

passing the first flexible device through the left intervertebral foramen and out of the patient;

inserting the first or a second flexible device through the same access location, through the interlaminar window, and to the spine location;

advancing the first or the second flexible device from the spine location, and laterally through the right intervertebral foramen; and

passing through the right intervertebral foramen and out of the patient.