US20030195518A1 — Methods and apparatus for performing therapeutic …

Claim 1

Independent Claim 142 words

1 . Apparatus for obtaining access to a series of adjacent vertebral bodies located within a human lumbar and sacral spine, the vertebral bodies separated by intact or damaged intervertebral spinal discs, and performing disc augmentation of a selected spinal disc, the apparatus comprising: means for exposing a sacral position of a sacral vertebra in alignment with a visualized, axial instrumentation/fusion line extending in said axial aspect through the series of adjacent vertebral bodies; bore forming means operable from the exposed sacral position for boring a trans-sacral axial bore axially through the vertebral bodies of said series of adjacent vertebral bodies and forming an axial disc opening into or through any intervertebral, spinal discs; and means for performing a disc augmentation of any of the spinal discs through the axial bore and axial disc opening exposed or traversed by said axial bore.

Claim 2

Dependent Claim 142 words

1 . Apparatus for obtaining access to a series of adjacent vertebral bodies located within a human lumbar and sacral spine, the vertebral bodies separated by intact or damaged intervertebral spinal discs, and performing disc augmentation of a selected spinal disc, the apparatus comprising: means for exposing a sacral position of a sacral vertebra in alignment with a visualized, axial instrumentation/fusion line extending in said axial aspect through the series of adjacent vertebral bodies; bore forming means operable from the exposed sacral position for boring a trans-sacral axial bore axially through the vertebral bodies of said series of adjacent vertebral bodies and forming an axial disc opening into or through any intervertebral, spinal discs; and means for performing a disc augmentation of any of the spinal discs through the axial bore and axial disc opening exposed or traversed by said axial bore.

Claim 3

Dependent Claim 52 words

2 . The apparatus of claim 1 , further comprising means for performing a discectomy through the axial bore and the disc opening to remove at least a portion of the nucleus leaving a disc cavity enclosed by the annulus prior to insertion of a disc augmentation catheter into said axial bore.

Claim 4

Dependent Claim 124 words

3 . The apparatus of claim 1 , wherein said means for performing a disc augmentation comprises: a disc augmentation catheter having a disc augmentation catheter body and disc augmentation catheter lumen extending between a disc augmentation catheter proximal end and a disc augmentation catheter distal end, the disc augmentation catheter distal end adapted to be advanced through said axial bore and laterally into or adjacent to the interior of a spinal disc body traversed and exposed by the axial bore; and a disc augmentation material delivery means coupled to the disc augmentation catheter proximal end for delivery of disc augmentation materials through said disc augmentation catheter lumen and from said disc augmentation catheter distal end and into the interior of the disc body.

Claim 5

Dependent Claim 51 words

4 . The apparatus of claim 1 , further comprising means for performing a discectomy through the axial bore and the disc opening to remove at least a portion of the nucleus and the annulus leaving a disc space prior to insertion of said disc augmentation catheter into said axial bore.

Claim 6

Dependent Claim 117 words

5 . Apparatus for obtaining access to a series of adjacent vertebral bodies located within a human spine, the vertebral bodies separated by intact or damaged intervertebral spinal discs normally formed of a nucleus and annulus, and performing a therapy, the apparatus comprising: a means for exposing an anterior sacral position of an anterior sacral vertebral body; bore forming means operable from the exposed sacral position for boring a trans-sacral axial bore cephalad and axially through or into at least one cephalad vertebral body and intervertebral disc; and means for performing a therapeutic procedure in one of a vertebral body or spinal disc located within a human lumbar and sacral spine accessed through the trans-sacral axial bore.

Claim 7

Dependent Claim 117 words

5 . Apparatus for obtaining access to a series of adjacent vertebral bodies located within a human spine, the vertebral bodies separated by intact or damaged intervertebral spinal discs normally formed of a nucleus and annulus, and performing a therapy, the apparatus comprising: a means for exposing an anterior sacral position of an anterior sacral vertebral body; bore forming means operable from the exposed sacral position for boring a trans-sacral axial bore cephalad and axially through or into at least one cephalad vertebral body and intervertebral disc; and means for performing a therapeutic procedure in one of a vertebral body or spinal disc located within a human lumbar and sacral spine accessed through the trans-sacral axial bore.

Claim 8

Dependent Claim 60 words

6 . The apparatus of claim 5 , wherein the bore forming means comprises means for boring a curved anterior axial bore aligned with an anterior axial instrumentation/fusion line cephalad through the vertebral bodies of said series of adjacent vertebrae and any intervertebral, spinal discs, the anterior axial bore having a bore curvature in the posterior-anterior plane of the spine.

Claim 9

Dependent Claim 49 words

7 . The apparatus of claim 6 , wherein the means for performing a therapeutic procedure comprises an axial spinal implant adapted to be implanted into said axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body.

Claim 10

Dependent Claim 49 words

8 . The apparatus of claim 5 , wherein the means for performing a therapeutic procedure comprises an axial spinal implant adapted to be implanted into said axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body.

Claim 11

Dependent Claim 28 words

9 . The apparatus of claim 5 , wherein the means for performing a therapeutic procedure comprises means for implanting a bone growth material into the axial bore.

Claim 12

Dependent Claim 109 words

10 . The apparatus of claim 5 , wherein the bore forming means comprises means for boring the axial bore through a caudal vertebral body, an intervertebral spinal disc, and into a cephalad vertebral body, whereby the axial bore traverses the spinal disc; and the means for performing a therapeutic procedure comprises: an axial spinal implant adapted to be implanted into the axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body and through any intervertebral, spinal discs; and a bone growth material adapted to be implanted into the axial bore along with the axial spinal implant.

Claim 13

Dependent Claim 95 words

11 . The apparatus of claim 5 , wherein: the bore forming means comprises means for boring the axial bore through a caudal vertebral body and making an axial disc opening into an intervertebral spinal disc; and the means for performing a therapeutic procedure comprises: means for performing a partial discectomy through the axial bore and the disc opening to remove at least a substantial portion of the nucleus leaving a disc cavity enclosed by the annulus; and an augmentation device or material adapted to be inserted through said disc opening into the disc cavity.

Claim 14

Dependent Claim 76 words

12 . The apparatus of claim 5 , wherein: the bore forming means comprises means for boring the axial bore through a caudal vertebral body and making an axial disc opening into an intervertebral spinal disc; and the means for performing a therapeutic procedure comprises means for performing a complete discectomy through the axial bore and the disc opening to remove substantially all of the nucleus and annulus of the spinal disc leaving a disc space.

Claim 15

Dependent Claim 42 words

13 . The apparatus of claim 12 , wherein the means for performing a therapeutic procedure further comprises a spinal disc implant replacement device or material adapted to be inserted through said axial bore and said disc opening into the disc space.

Claim 16

Dependent Claim 175 words

14 . The apparatus of claim 5 , wherein the bore forming means comprises means for boring the axial bore through a caudal vertebral body, an intervertebral spinal disc, and into a cephalad vertebral body, whereby the axial bore traverses the spinal disc; and the means for performing a therapeutic procedure comprises: means for performing a discectomy through the axial bore and the disc opening to remove all of the nucleus and annulus of the spinal disc leaving a disc space or at least a portion of the nucleus leaving a disc cavity within the annulus; a spinal disc implant device or material adapted to be inserted through said axial bore and into said disc space or disc cavity and having a through-hole adapted to be aligned with said axial bore; an axial spinal implant adapted to be implanted into the axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body and through the through-hole of the spinal disc implant device or material.

Claim 17

Dependent Claim 175 words

15 . Apparatus for obtaining access to a series of adjacent vertebral bodies located within a human spine, the vertebral bodies separated by intact or damaged intervertebral spinal discs normally formed of a nucleus and annulus, and performing therapy, the apparatus comprising: means for exposing one of an anterior or posterior sacral position of a sacral vertebra in alignment with a visualized, anterior or posterior axial instrumentation/fusion line extending in said axial aspect through the series of adjacent vertebral bodies; bore forming means operable from the exposed anterior or posterior sacral position for boring a curved anterior or posterior trans-sacral axial bore in alignment with said anterior or posterior axial instrumentation/fusion line extending cephalad and axially through or into at least one cephalad vertebral body and intervertebral disc, the anterior or posterior axial bore having a bore curvature in the posterior-anterior plane of the spine; and means for performing a therapeutic procedure in one of a vertebral body or spinal disc located within a human lumbar and sacral spine accessed through the trans-sacral axial bore.

Claim 18

Dependent Claim 175 words

15 . Apparatus for obtaining access to a series of adjacent vertebral bodies located within a human spine, the vertebral bodies separated by intact or damaged intervertebral spinal discs normally formed of a nucleus and annulus, and performing therapy, the apparatus comprising: means for exposing one of an anterior or posterior sacral position of a sacral vertebra in alignment with a visualized, anterior or posterior axial instrumentation/fusion line extending in said axial aspect through the series of adjacent vertebral bodies; bore forming means operable from the exposed anterior or posterior sacral position for boring a curved anterior or posterior trans-sacral axial bore in alignment with said anterior or posterior axial instrumentation/fusion line extending cephalad and axially through or into at least one cephalad vertebral body and intervertebral disc, the anterior or posterior axial bore having a bore curvature in the posterior-anterior plane of the spine; and means for performing a therapeutic procedure in one of a vertebral body or spinal disc located within a human lumbar and sacral spine accessed through the trans-sacral axial bore.

Claim 19

Dependent Claim 49 words

16 . The apparatus of claim 15 , wherein the means for performing a therapeutic procedure comprises an axial spinal implant adapted to be implanted into said axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body.

Claim 20

Dependent Claim 176 words

17 . The apparatus of claim 15 , wherein the bore forming means comprises means for boring the axial bore through a caudal vertebral body, an intervertebral spinal disc, and into a cephalad vertebral body, whereby the axial bore traverses the spinal disc; and the means for performing a therapeutic procedure comprises: means for performing a discectomy through the axial bore and the disc opening to remove a portion of the nucleus and annulus of the spinal disc leaving a disc space or at least a portion of the nucleus leaving a disc cavity within the annulus; a spinal disc implant device or material adapted to be inserted through said axial bore and into said disc space or disc cavity and having a through-hole adapted to be aligned with said axial bore; an axial spinal implant adapted to be implanted into the axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body and through the through-hole of the spinal disc implant device or material.

Claim 21

Dependent Claim 29 words

18 . The apparatus of claim 17 , wherein the means for performing a therapeutic procedure further comprises means for implanting a bone growth material into the axial bore.

Claim 22

Dependent Claim 109 words

19 . The apparatus of claim 15 , wherein the bore forming means comprises means for boring the axial bore through a caudal vertebral body, an intervertebral spinal disc, and into a cephalad vertebral body, whereby the axial bore traverses the spinal disc; and the means for performing a therapeutic procedure comprises: an axial spinal implant adapted to be implanted into the axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body and through any intervertebral, spinal discs; and a bone growth material adapted to be implanted into the axial bore along with the axial spinal implant.

Claim 23

Dependent Claim 75 words

20 . The apparatus of claim 15 , wherein: the bore forming means comprises means for boring the axial bore through a caudal vertebral body and making an axial disc opening into an intervertebral spinal disc; and the means for performing a therapeutic procedure comprises means for performing a discectomy through the axial bore and the disc opening to remove at least a portion of the nucleus leaving a disc cavity enclosed by the annulus.

Claim 24

Dependent Claim 94 words

21 . The apparatus of claim 15 , wherein: the bore forming means comprises means for boring the axial bore through a caudal vertebral body and making an axial disc opening into an intervertebral spinal disc; and the means for performing a therapeutic procedure comprises: means for performing a partial discectomy through the axial bore and the disc opening to remove at least a portion of the nucleus leaving a disc cavity enclosed by the annulus; and an augmentation device or material adapted to be inserted through said disc opening into the disc cavity.

Claim 25

Dependent Claim 77 words

22 . The apparatus of claim 15 , wherein: the bore forming means comprises means for boring the axial bore through a caudal vertebral body and making an axial disc opening into an intervertebral spinal disc; and the means for performing a therapeutic procedure comprises means for performing a discectomy through the axial bore and the disc opening to remove at least a portion of the nucleus and annulus of the spinal disc leaving a disc space.

Claim 26

Dependent Claim 38 words

23 . The apparatus of claim 22 , wherein the means for performing a therapeutic procedure further comprises a spinal disc implant replacement device or material adapted to be inserted through said disc opening into the disc space.

Claim 27

Dependent Claim 160 words

24 . Apparatus for obtaining access to a series of adjacent vertebral bodies located within a human spine, the vertebral bodies separated by intact or damaged intervertebral spinal discs normally formed of a nucleus and annulus, and performing a therapy, the apparatus comprising: means for exposing a sacral position of a sacral vertebral body; bore forming means operable from the exposed sacral position for boring a trans-sacral axial bore extending cephalad and axially through a caudal vertebral body, an intervertebral spinal disc, and into a cephalad vertebral body, whereby the axial bore traverses the spinal disc; a spinal disc implant having a through-hole; means for implanting the spinal disc implant within the intervertebral disc space traversed by the axial bore with the through-hole aligned with the axial bore; and an axial spinal implant adapted to be implanted into said axial bore to extend cephalad through the caudal vertebral body, through the through-hole and into or through the cephalad vertebral body.

Claim 28

Dependent Claim 160 words

24 . Apparatus for obtaining access to a series of adjacent vertebral bodies located within a human spine, the vertebral bodies separated by intact or damaged intervertebral spinal discs normally formed of a nucleus and annulus, and performing a therapy, the apparatus comprising: means for exposing a sacral position of a sacral vertebral body; bore forming means operable from the exposed sacral position for boring a trans-sacral axial bore extending cephalad and axially through a caudal vertebral body, an intervertebral spinal disc, and into a cephalad vertebral body, whereby the axial bore traverses the spinal disc; a spinal disc implant having a through-hole; means for implanting the spinal disc implant within the intervertebral disc space traversed by the axial bore with the through-hole aligned with the axial bore; and an axial spinal implant adapted to be implanted into said axial bore to extend cephalad through the caudal vertebral body, through the through-hole and into or through the cephalad vertebral body.

Claim 29

Dependent Claim 39 words

25 . The apparatus of claim 24 , wherein at least one of the spinal disc implant and the axial spinal implant are formed of bone growth materials that promote the fusion of the cephalad and caudal vertebral bodies.

Claim 30

Dependent Claim 108 words

26 . Apparatus for obtaining access to a series of adjacent vertebral bodies located within a human spine, the vertebral bodies separated by intact or damaged intervertebral spinal discs and repairing a damaged vertebral body, the apparatus comprising: means for exposing a sacral position of a sacral vertebral body; bore forming means operable from the exposed sacral position for boring a trans-sacral axial bore extending cephalad and axially through a caudal vertebral body, any intervertebral spinal disc, and into a fractured cephalad vertebral body; and means for performing a vertebroplasty of the fractured vertebral body through the axial bore to repair damage and strengthen the fractured vertebral body.

Claim 31

Dependent Claim 108 words

26 . Apparatus for obtaining access to a series of adjacent vertebral bodies located within a human spine, the vertebral bodies separated by intact or damaged intervertebral spinal discs and repairing a damaged vertebral body, the apparatus comprising: means for exposing a sacral position of a sacral vertebral body; bore forming means operable from the exposed sacral position for boring a trans-sacral axial bore extending cephalad and axially through a caudal vertebral body, any intervertebral spinal disc, and into a fractured cephalad vertebral body; and means for performing a vertebroplasty of the fractured vertebral body through the axial bore to repair damage and strengthen the fractured vertebral body.

Claim 32

Dependent Claim 88 words

27 . The apparatus of claim 26 , wherein the vertebroplasty performing means comprises: a vertebroplasty catheter having a vertebroplasty catheter lumen adapted to be extended through said axial bore and laterally into cancellous bone of the damaged vertebral body exposed by said axial bore; and a vertebral body reinforcing material for reinforcing the vertebral body; and means for injecting the vertebral body reinforcing material through the vertebroplasty catheter lumen into cancellous bone within the vertebral body and filling the axial bore extending into the fractured vertebral body.

Claim 33

Dependent Claim 109 words

28 . Apparatus for obtaining access to a series of adjacent vertebral bodies located within a human spine, the vertebral bodies separated by intact or damaged intervertebral spinal discs, and repairing a damaged vertebral body, the apparatus comprising: means for exposing a sacral position of a sacral vertebral body; bore forming means operable from the exposed sacral position for boring a trans-sacral axial bore extending cephalad and axially through a caudal vertebral body, any intervertebral spinal disc, and into a fractured cephalad vertebral body; and means for performing a balloon-assisted vertebroplasty of the fractured vertebral body through the axial bore to repair damage and strengthen the fractured vertebral body.

Claim 34

Dependent Claim 109 words

28 . Apparatus for obtaining access to a series of adjacent vertebral bodies located within a human spine, the vertebral bodies separated by intact or damaged intervertebral spinal discs, and repairing a damaged vertebral body, the apparatus comprising: means for exposing a sacral position of a sacral vertebral body; bore forming means operable from the exposed sacral position for boring a trans-sacral axial bore extending cephalad and axially through a caudal vertebral body, any intervertebral spinal disc, and into a fractured cephalad vertebral body; and means for performing a balloon-assisted vertebroplasty of the fractured vertebral body through the axial bore to repair damage and strengthen the fractured vertebral body.

Claim 35

Dependent Claim 124 words

29 . The apparatus of claim 28 , wherein the balloon-assisted vertebroplasty performing means comprises: a balloon catheter having a balloon catheter lumen and bearing a deflated balloon adapted to be extended through said axial bore to locate the deflated balloon in relation to cancellous bone of the damaged vertebral body exposed by said axial bore; means for inflating the balloon of the balloon catheter through the balloon catheter lumen to apply force to cancellous bone and compress cancellous bone to form a vertebral body cavity; means for deflating the balloon; and means for injecting a vertebral body reinforcing material for reinforcing the vertebral body into one of the vertebral body cavity and cancellous bone within the vertebral body or into the deflated balloon.

Claim 36

Dependent Claim 153 words

30 . Apparatus for obtaining access to a series of adjacent vertebral bodies located within a human spine, the vertebral bodies separated by intact or damaged intervertebral spinal discs normally formed of a nucleus and annulus, and performing a therapy, the apparatus comprising: means for exposing a sacral position of a sacral vertebral body; bore forming means operable from the exposed sacral position for boring a trans-sacral axial bore extending cephalad and axially through a caudal vertebral body, an intervertebral spinal disc, and into a cephalad vertebral body, whereby the axial bore traverses the spinal disc; and a distracting axial spinal implant adapted to be extended into said axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body. means for desiccating at least a portion of the nucleus to form a disc cavity; and means for aspirating byproducts of the desiccation.

Claim 37

Dependent Claim 153 words

30 . Apparatus for obtaining access to a series of adjacent vertebral bodies located within a human spine, the vertebral bodies separated by intact or damaged intervertebral spinal discs normally formed of a nucleus and annulus, and performing a therapy, the apparatus comprising: means for exposing a sacral position of a sacral vertebral body; bore forming means operable from the exposed sacral position for boring a trans-sacral axial bore extending cephalad and axially through a caudal vertebral body, an intervertebral spinal disc, and into a cephalad vertebral body, whereby the axial bore traverses the spinal disc; and a distracting axial spinal implant adapted to be extended into said axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body. means for desiccating at least a portion of the nucleus to form a disc cavity; and means for aspirating byproducts of the desiccation.

Claim 38

Dependent Claim 128 words

31 . A method for performing a therapeutic procedure on one or more of a series of vertebral bodies or any intervertebral spinal disc normally formed of a nucleus and annulus and separating adjacent vertebral bodies of a human spine, the method comprising: accessing a posterior sacral position of a sacral vertebral body; from the accessed posterior sacral position, forming a trans-sacral axial bore cephalad and axially through at least the caudal sacral vertebra and through or into at least one cephalad vertebral body of said series of adjacent vertebral bodies and through or into at least one intervertebral spinal disc; and performing a therapeutic procedure in one or both of a vertebral body or spinal disc located within a human spine accessed through the trans-sacral axial bore.

Claim 39

Dependent Claim 128 words

31 . A method for performing a therapeutic procedure on one or more of a series of vertebral bodies or any intervertebral spinal disc normally formed of a nucleus and annulus and separating adjacent vertebral bodies of a human spine, the method comprising: accessing a posterior sacral position of a sacral vertebral body; from the accessed posterior sacral position, forming a trans-sacral axial bore cephalad and axially through at least the caudal sacral vertebra and through or into at least one cephalad vertebral body of said series of adjacent vertebral bodies and through or into at least one intervertebral spinal disc; and performing a therapeutic procedure in one or both of a vertebral body or spinal disc located within a human spine accessed through the trans-sacral axial bore.

Claim 40

Dependent Claim 51 words

32 . The method of claim 31 , wherein the bore forming step comprises boring a curved posterior axial bore cephalad through the vertebral bodies of said series of adjacent vertebrae and any intervertebral, spinal discs, the posterior axial bore having a bore curvature in the posterior-anterior plane of the spine.

Claim 41

Dependent Claim 42 words

33 . The method of claim 31 , wherein the step of performing a therapeutic procedure comprises performing disc augmentation of any of the spinal discs through the axial bore and the axial disc opening exposed or traversed by the axial bore.

Claim 42

Dependent Claim 46 words

34 . The method of claim 31 , wherein the step of performing a therapeutic procedure comprises implanting an axial spinal implant into the axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body.

Claim 43

Dependent Claim 105 words

35 . The method of claim 31 , wherein: the bore forming step comprises boring the axial bore through a caudal vertebral body, an intervertebral spinal disc, and into a cephalad vertebral body, whereby the axial bore traverses the spinal disc; and the step of performing a therapeutic procedure comprises: implanting a spinal disc implant having a through-hole within the intervertebral disc space traversed by the axial bore with the through-hole aligned with the axial bore; and implanting an axial spinal implant into said axial bore to extend cephalad through the caudal vertebral body, through the through-hole and into or through the cephalad vertebral body.

Claim 44

Dependent Claim 39 words

36 . The method of claim 35 , wherein at least one of the spinal disc implant and the axial spinal implant are formed of bone growth materials that promote the fusion of the cephalad and caudal vertebral bodies.

Claim 45

Dependent Claim 39 words

37 . The method of claim 31 , wherein the step of performing a therapeutic procedure comprises implanting a bone growth material into the axial bore and into cancellous bone of a vertebral body penetrated by the axial bore.

Claim 46

Dependent Claim 68 words

38 . The method of claim 31 , wherein the step of performing a therapeutic procedure comprises: implanting an axial spinal implant into the axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body and through any intervertebral, spinal discs; and implanting a bone growth material into the axial bore along with the axial spinal implant.

Claim 47

Dependent Claim 71 words

39 . The method of claim 31 , wherein: the bore forming step comprises boring the axial bore through a caudal vertebral body and making an axial disc opening into an intervertebral spinal disc; and the step of performing a therapeutic procedure comprises performing a discectomy through the axial bore and the disc opening to remove at least a portion of the nucleus leaving a disc cavity enclosed by the annulus.

Claim 48

Dependent Claim 87 words

40 . The method of claim 31 , wherein: the bore forming step comprises boring the axial bore through a caudal vertebral body and making an axial disc opening into an intervertebral spinal disc; and the step of performing a therapeutic procedure comprises: performing a partial discectomy through the axial bore and the disc opening to remove at least a portion of the nucleus leaving a disc cavity enclosed by the annulus; and inserting an augmentation device or material through said disc opening into the disc cavity.

Claim 49

Dependent Claim 73 words

41 . The method of claim 31 , wherein: the bore forming step comprises boring the axial bore through a caudal vertebral body and making an axial disc opening into an intervertebral spinal disc; and the step of performing a therapeutic procedure comprises performing a discectomy through the axial bore and the disc opening to remove at least a portion of the nucleus and annulus of the spinal disc leaving a disc space.

Claim 50

Dependent Claim 57 words

42 . The method of claim 31 , wherein: the bore forming step comprises boring a trans-sacral axial bore exposing cancellous bone of a fractured vertebral body; and the step of performing a therapeutic procedure comprises performing a vertebroplasty of the fractured vertebral body through the axial bore to repair damage and strengthen the fractured vertebral body.

Claim 51

Dependent Claim 71 words

43 . The method of claim 42 , wherein the vertebroplasty performing step comprises the steps of: extending a vertebroplasty catheter having a vertebroplasty catheter lumen through said axial bore and into the damaged vertebral body exposed by said axial bore; and injecting a vertebral body reinforcing material for reinforcing the vertebral body into cancellous bone within the vertebral body and filling the axial bore extending into the fractured vertebral body.

Claim 52

Dependent Claim 64 words

44 . The method of claim 31 , wherein: the bore forming step comprises the step of boring a trans-sacral axial bore exposing cancellous bone of a fractured vertebral body; and the step of performing a therapeutic procedure comprises the step of performing a balloon-assisted vertebroplasty of the fractured vertebral body through the axial bore to repair damage and strengthen the fractured vertebral body.

Claim 53

Dependent Claim 118 words

45 . The method of claim 44 , wherein the balloon-assisted vertebroplasty performing step comprises the steps of: extending a balloon catheter having a balloon catheter lumen and bearing a deflated balloon through said axial bore to locate the deflated balloon in relation to cancellous bone of the damaged vertebral body exposed by said axial bore; inflating the balloon of the balloon catheter through the balloon catheter lumen to apply force to cancellous bone and compress cancellous bone to form a vertebral body cavity; deflating the balloon; and injecting a vertebral body reinforcing material for reinforcing the vertebral body into one of the vertebral body cavity and cancellous bone within the vertebral body or into the deflated balloon.

Claim 54

Dependent Claim 72 words

46 . The method of claim 31 , wherein the step of performing a therapeutic procedure comprises the steps of: introducing a medical electrical stimulation lead into the trans-sacral axial bore and locating electrical stimulation electrodes of the electrical stimulation lead in relation to a spinal structure of interest for electrical stimulation; and applying electrical stimulation to the spinal structure of interest through the electrical stimulation lead and from the stimulation electrodes.

Claim 55

Dependent Claim 78 words

47 . The method of claim 31 , wherein the step of performing a therapeutic procedure comprises the steps of: introducing a drug delivery catheter having a drug delivery lumen and at least one drug delivery port into the trans-sacral axial bore and locating each drug delivery port in relation to a spinal structure of interest to be treated; and delivering a drug to the structure of interest through the drug delivery lumen and the drug delivery port.

Claim 56

Dependent Claim 48 words

48 . The method of claim 31 , wherein the step of performing a therapeutic procedure comprises implanting a shock absorbing axial spinal implant into said axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body.

Claim 57

Dependent Claim 47 words

49 . The method of claim 31 , wherein the step of performing a therapeutic procedure comprises implanting a distracting axial spinal implant into said axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body.

Claim 58

Dependent Claim 83 words

50 . The method of claim 31 , wherein: the bore forming step comprises boring the axial bore through a caudal vertebral body and making an axial disc opening into an intervertebral spinal disc; and the step of performing a therapeutic procedure comprises introducing a discectomy instrument through the axial bore and disc opening and performing a discectomy through the axial bore and the disc opening to remove at least a portion of the nucleus leaving a disc cavity enclosed by the annulus.

Claim 59

Dependent Claim 74 words

51 . The method of claim 50 , wherein the discectomy instrument has a discectomy instrument fragmentation head and an aspiration lumen with an aspiration lumen opening, and the discectomy performing step comprises the steps of: positioning the fragmentation head and aspiration lumen opening in operative relation to the nucleus; operating the fragmentation head to fragment the nucleus to form the disc cavity; and aspirating the nucleus fragments through the discectomy instrument aspiration lumen.

Claim 60

Dependent Claim 77 words

52 . The method of claim 50 , wherein the discectomy instrument has a discectomy instrument energy emitting head and an aspiration lumen with an aspiration lumen opening, and the discectomy performing step comprises the steps of: positioning the energy emitting head and aspiration lumen opening in operative relation to the nucleus; operating the energy emitting head to desiccate the nucleus to form the disc cavity; and aspirating byproducts of desiccation through the discectomy instrument aspiration lumen.

Claim 61

Dependent Claim 85 words

53 . The method of claim 31 , wherein: the bore forming step comprises boring the axial bore through a caudal vertebral body and making an axial disc opening into an intervertebral spinal disc; and the step of performing a therapeutic procedure comprises introducing a discectomy instrument through the axial bore and disc opening and performing a discectomy through the axial bore and the disc opening to remove at least a portion of the nucleus and annulus of the spinal disc leaving a disc space.

Claim 62

Dependent Claim 88 words

54 . The method of claim 53 , wherein the discectomy instrument has a discectomy instrument fragmentation head and an aspiration lumen with an aspiration lumen opening, and the discectomy performing step comprises the steps of: positioning the fragmentation head and aspiration lumen opening in operative relation to the nucleus and annulus of the spinal disc; operating the fragmentation head to fragment the nucleus and annulus of the spinal disc to form the disc space; and aspirating the nucleus and annulus fragments through the discectomy instrument aspiration lumen.

Claim 63

Dependent Claim 85 words

55 . The method of claim 53 , wherein the discectomy instrument has a discectomy instrument energy emitting head and an aspiration lumen with an aspiration lumen opening, and the discectomy performing step comprises the steps of: positioning the energy emitting head and aspiration lumen opening in operative relation to the nucleus and annulus; operating the energy emitting head to desiccate the nucleus and annulus of the spinal disc to form the disc space; and aspirating byproducts of desiccation through the discectomy instrument aspiration lumen.

Claim 64

Dependent Claim 40 words

56 . The method of claim 31 , wherein the step of performing a therapeutic procedure comprises the step of introducing at least one radiation emitting implant to a selected site in relation to a sarcoma through the axial bore.

Claim 65

Dependent Claim 98 words

57 . The method of claim 31 , wherein: the bore forming step comprises boring the axial bore through a caudal vertebral body and making an axial disc opening into an intervertebral spinal disc; and the step of performing a therapeutic procedure comprises performing a discectomy of the intervertebral spinal disc accessed by the axial bore through the axial bore and disc opening to remove all or substantially all of the disc body and leaving a disc space between the vertebral bodies or at least a portion of the nucleus and leaving a disc cavity within the annulus.

Claim 66

Dependent Claim 74 words

58 . The method of claim 57 , wherein the step of performing a discectomy comprises the steps of: extending a discectomy instrument to the accessed sacral position and through said axial bore and disc opening to the interior of the spinal disc; and operating the discectomy instrument to remove at least a portion of the nucleus to form a disc cavity within the annulus and between the caudal and cephalad vertebral body endplates.

Claim 67

Dependent Claim 78 words

59 . The method of claim 57 , wherein the step of performing a discectomy comprises the steps of: extending a discectomy instrument to the accessed sacral position and through said axial bore and disc opening to the interior of the spinal disc; and operating the discectomy instrument to remove at least a portion of the caudal and cephalad cartilaginous endplates to form an open disc space or disc cavity between the caudal and cephalad vertebral body endplates.

Claim 68

Dependent Claim 94 words

60 . The method of claim 57 , wherein the step of performing a discectomy comprises the steps of: extending a discectomy instrument to the accessed sacral position and through said axial bore and disc opening to the interior of the spinal disc; and operating the discectomy instrument to remove at least a portion of the caudal and cephalad cartilaginous endplates and a portion of the caudal and cephalad vertebral body end plates to form an open disc space or disc cavity extending axially into cancellous bone of the caudal and cephalad vertebral bodies.

Claim 69

Dependent Claim 88 words

61 . The method of claim 57 , wherein the step of performing a discectomy comprises the steps of: extending a discectomy instrument having a discectomy instrument fragmentation head and an aspiration lumen with an aspiration lumen opening through said axial bore; locating the fragmentation head and aspiration lumen opening within the spinal disc opening; operating the fragmentation head to fragment portions or substantially all of the disc body to form the disc space or disc cavity; and aspirating disc body fragments through the discectomy instrument aspiration lumen.

Claim 70

Dependent Claim 92 words

62 . The method of claim 57 , wherein the step of performing a discectomy comprises the steps of: extending a discectomy instrument having a discectomy instrument energy emitting head and an aspiration lumen with an aspiration lumen opening through said axial bore; locating the energy emitting head and aspiration lumen opening within the spinal disc opening; operating the energy emitting head to desiccate portions of or substantially all of the disc body to form the disc space or disc cavity; and aspirating byproducts of desiccation through the discectomy instrument aspiration lumen.

Claim 71

Dependent Claim 159 words

63 . A method for performing a therapeutic procedure of an intervertebral spinal disc of a human spine, the spinal disc having a disc body comprising caudal and cephalad cartilaginous endplates adhered to the respective opposed endplates of adjacent caudal and cephalad vertebral bodies and joined together by a disc annulus and enclosing a disc nucleus, the method comprising the steps of: accessing one of an anterior or posterior sacral position of a sacral vertebral body; from the accessed sacral position, boring a curved trans-sacral axial bore cephalad and axially through at least the caudal sacral vertebra and through or into one or more cephalad vertebral bodies of said series of adjacent vertebral bodies and through or into at least one intervertebral spinal disc, thereby forming an axial disc opening; and performing a therapeutic procedure in one or both of a vertebral body or spinal disc located within a human spine accessed through the axial bore and disc opening.

Claim 72

Dependent Claim 159 words

63 . A method for performing a therapeutic procedure of an intervertebral spinal disc of a human spine, the spinal disc having a disc body comprising caudal and cephalad cartilaginous endplates adhered to the respective opposed endplates of adjacent caudal and cephalad vertebral bodies and joined together by a disc annulus and enclosing a disc nucleus, the method comprising the steps of: accessing one of an anterior or posterior sacral position of a sacral vertebral body; from the accessed sacral position, boring a curved trans-sacral axial bore cephalad and axially through at least the caudal sacral vertebra and through or into one or more cephalad vertebral bodies of said series of adjacent vertebral bodies and through or into at least one intervertebral spinal disc, thereby forming an axial disc opening; and performing a therapeutic procedure in one or both of a vertebral body or spinal disc located within a human spine accessed through the axial bore and disc opening.

Claim 73

Dependent Claim 42 words

64 . The method of claim 63 , wherein the step of performing a therapeutic procedure comprises performing disc augmentation of any of the spinal discs through the axial bore and the axial disc opening exposed or traversed by the axial bore.

Claim 74

Dependent Claim 46 words

65 . The method of claim 63 , wherein the step of performing a therapeutic procedure comprises implanting an axial spinal implant into the axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body.

Claim 75

Dependent Claim 39 words

66 . The method of claim 63 , wherein the step of performing a therapeutic procedure comprises implanting a bone growth material into the axial bore and into cancellous bone of a vertebral body penetrated by the axial bore

Claim 76

Dependent Claim 45 words

67 . The method of claim 63 , wherein the step of performing a therapeutic procedure comprises performing a discectomy through the axial bore and the disc opening to remove at least a portion of the nucleus leaving a disc cavity enclosed by the annulus.

Claim 77

Dependent Claim 47 words

68 . The method of claim 63 , wherein the step of performing a therapeutic procedure comprises performing a discectomy through the axial bore and the disc opening to remove at least a portion of the nucleus and annulus of the spinal disc leaving a disc space.

Claim 78

Dependent Claim 57 words

69 . The method of claim 63 , wherein: the bore forming step comprises boring a trans-sacral axial bore exposing cancellous bone of a fractured vertebral body; and the step of performing a therapeutic procedure comprises performing a vertebroplasty of the fractured vertebral body through the axial bore to repair damage and strengthen the fractured vertebral body.

Claim 79

Dependent Claim 58 words

70 . The method of claim 63 , wherein: the bore forming step comprises boring a trans-sacral axial bore exposing cancellous bone of a fractured vertebral body; and the step of performing a therapeutic procedure comprises performing a balloon-assisted vertebroplasty of the fractured vertebral body through the axial bore to repair damage and strengthen the fractured vertebral body.

Claim 80

Dependent Claim 72 words

71 . The method of claim 63 , wherein the step of performing a therapeutic procedure comprises the steps of: introducing a medical electrical stimulation lead into the trans-sacral axial bore and locating electrical stimulation electrodes of the electrical stimulation lead in relation to a spinal structure of interest for electrical stimulation; and applying electrical stimulation to the spinal structure of interest through the electrical stimulation lead and from the stimulation electrodes.

Claim 81

Dependent Claim 78 words

72 . The method of claim 63 , wherein the step of performing a therapeutic procedure comprises the steps of: introducing a drug delivery catheter having a drug delivery lumen and at least one drug delivery port into the trans-sacral axial bore and locating each drug delivery port in relation to a spinal structure of interest to be treated; and delivering a drug to the structure of interest through the drug delivery lumen and the drug delivery port.

Claim 82

Dependent Claim 48 words

73 . The method of claim 63 , wherein the step of performing a therapeutic procedure comprises implanting a shock absorbing axial spinal implant into said axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body.

Claim 83

Dependent Claim 47 words

74 . The method of claim 63 , wherein the step of performing a therapeutic procedure comprises implanting a distracting axial spinal implant into said axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body.

Claim 84

Dependent Claim 40 words

75 . The method of claim 63 , wherein the step of performing a therapeutic procedure comprises the step of introducing at least one radiation emitting implant to a selected site in relation to a sarcoma through the axial bore.

Claim 85

Dependent Claim 114 words

76 . Apparatus for obtaining access to a series of adjacent vertebral bodies located within a human spine, the vertebral bodies separated by intervertebral spinal discs normally formed of a nucleus and annulus, and performing a therapy, the apparatus comprising: means for exposing an anterior sacral position of an anterior sacral vertebral body; bore forming means operable from the exposed anterior sacral position for boring a trans-sacral axial bore cephalad and axially through or into at least one cephalad vertebral body and intervertebral disc; and means for performing a therapeutic procedure in one of a vertebral body or spinal disc located within a human lumbar and sacral spine accessed through the trans-sacral axial bore.

Claim 86

Dependent Claim 114 words

76 . Apparatus for obtaining access to a series of adjacent vertebral bodies located within a human spine, the vertebral bodies separated by intervertebral spinal discs normally formed of a nucleus and annulus, and performing a therapy, the apparatus comprising: means for exposing an anterior sacral position of an anterior sacral vertebral body; bore forming means operable from the exposed anterior sacral position for boring a trans-sacral axial bore cephalad and axially through or into at least one cephalad vertebral body and intervertebral disc; and means for performing a therapeutic procedure in one of a vertebral body or spinal disc located within a human lumbar and sacral spine accessed through the trans-sacral axial bore.

Claim 87

Dependent Claim 59 words

77 . The apparatus of claim 76 , wherein the bore forming means comprises means for boring a curved anterior axial bore aligned with an anterior axial instrumentation/fusion line cephalad through the vertebral bodies of said series of adjacent vertebrae and any intervertebral spinal discs, the axial bore having a bore curvature in the posterior-anterior plane of the spine.

Claim 88

Dependent Claim 49 words

78 . The apparatus of claim 77 , wherein the means for performing a therapeutic procedure comprises an axial spinal implant adapted to be implanted into the axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body.

Claim 89

Dependent Claim 49 words

79 . The apparatus of claim 76 , wherein the means for performing a therapeutic procedure comprises an axial spinal implant adapted to be implanted into the axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body.

Claim 90

Dependent Claim 28 words

80 . The apparatus of claim 76 , wherein the means for performing a therapeutic procedure comprises means for implanting a bone growth material into the axial bore.

Claim 91

Dependent Claim 109 words

81 . The apparatus of claim 76 , wherein: the bore forming means comprises means for boring the axial bore through a caudal vertebral body, an intervertebral spinal disc, and into a cephalad vertebral body, whereby the axial bore traverses the spinal disc; and the means for performing a therapeutic procedure comprises: an axial spinal implant adapted to be implanted into the axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body and through any intervertebral spinal discs; and a bone growth material adapted to be introducing into the axial bore along with the axial spinal implant.

Claim 92

Dependent Claim 29 words

82 . The apparatus of claim 76 , wherein the means for performing a therapeutic procedure comprises means for performing disc augmentation of at least one intervertebral spinal disc.

Claim 93

Dependent Claim 107 words

83 . The apparatus of claim 82 , wherein the means for performing disc augmentation comprises: a disc augmentation catheter having a catheter body and catheter lumen extending between a catheter proximal end and a catheter distal end, the catheter distal end adapted to be advanced through the axial bore and laterally into or adjacent to the interior of a spinal disc body traversed and exposed by the axial bore; and a disc augmentation material delivery means coupled to the catheter proximal end for delivery of disc augmentation materials through said catheter lumen and from said catheter distal end and into the interior of the disc body.

Claim 94

Dependent Claim 96 words

84 . The apparatus of claim 76 , wherein: the bore forming means comprises means for boring the axial bore through a caudal vertebral body and making an axial disc opening into an intervertebral spinal disc; and the means for performing a therapeutic procedure comprises: means for performing a partial discectomy through the axial bore and the disc opening to remove at least a portion of the nucleus leaving a disc cavity enclosed by the annulus; and at least one augmentation device or material adapted to be inserted through said disc opening into the disc cavity.

Claim 95

Dependent Claim 76 words

85 . The apparatus of claim 76 , wherein: the bore forming means comprises means for boring the axial bore through a caudal vertebral body and making an axial disc opening into an intervertebral spinal disc; and the means for performing a therapeutic procedure comprises means for performing a complete discectomy through the axial bore and the disc opening to remove substantially all of the nucleus and annulus of the spinal disc leaving a disc space.

Claim 96

Dependent Claim 42 words

86 . The apparatus of claim 85 , wherein the means for performing a therapeutic procedure further comprises a spinal disc implant replacement device or material adapted to be inserted through the axial bore and the disc opening into the disc space.

Claim 97

Dependent Claim 158 words

87 . The apparatus of claim 76 , wherein: the bore forming means comprises means for boring the axial bore through a caudal vertebral body, an intervertebral spinal disc, and into a cephalad vertebral body, whereby the axial bore traverses the spinal disc; and the means for performing a therapeutic procedure comprises: means for performing a discectomy through the axial bore and the disc opening to remove at least a portion of the nucleus leaving a disc cavity within the annulus; a spinal disc implant device or material adapted to be inserted through the axial bore and into the disc cavity and having a through-hole adapted to be aligned with the axial bore; and an axial spinal implant adapted to be implanted into the axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body and through the through-hole of the spinal disc implant device or material.

Claim 98

Dependent Claim 161 words

88 . The apparatus of claim 76 , wherein: the bore forming means comprises means for boring the axial bore through a caudal vertebral body, an intervertebral spinal disc, and into a cephalad vertebral body, whereby the axial bore traverses the spinal disc; and the means for performing a therapeutic procedure comprises: means for performing a discectomy through the axial bore and the disc opening to remove at least a portion of the nucleus and annulus of the spinal disc leaving a disc space; a spinal disc implant device or material adapted to be inserted through the axial bore and into the disc space and having a through-hole adapted to be aligned with the axial bore; and an axial spinal implant adapted to be implanted into the axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body and through the through-hole of the spinal disc implant device or material.

Claim 99

Dependent Claim 61 words

89 . The apparatus of claim 76 , wherein: the bore forming means comprises means for boring a trans-sacral axial bore exposing cancellous bone of a fractured vertebral body; and the means for performing a therapeutic procedure comprises means for performing a vertebroplasty of the fractured vertebral body through the axial bore to repair damage and strengthen the fractured vertebral body.

Claim 100

Dependent Claim 28 words

90 . The apparatus of claim 76 , wherein the means for performing a therapeutic procedure comprises means for applying electrical stimulation to a spinal structure of interest.

Claim 101

Dependent Claim 33 words

91 . The apparatus of claim 76 , wherein the means for performing a therapeutic procedure comprises means for delivering a drug to a spinal structure of interest through the trans-sacral axial bore.

Claim 102

Dependent Claim 41 words

92 . The apparatus of claim 76 , wherein the means for performing a therapeutic procedure comprises means for absorbing shock between at least one caudal vertebral body and at least one cephalad vertebral body from within the trans-sacral axial bore.

Claim 103

Dependent Claim 39 words

93 . The apparatus of claim 76 , wherein the means for performing a therapeutic procedure comprises means for distracting at least one caudal vertebral body and at least one cephalad vertebral body from within the trans-sacral axial bore.

Claim 104

Dependent Claim 27 words

94 . The apparatus of claim 76 , wherein the means for performing a therapeutic procedure comprises means for emitting radiation from within the trans-sacral axial bore.

Claim 105

Dependent Claim 114 words

95 . Apparatus for obtaining access to a series of adjacent vertebral bodies located within a human spine, the vertebral bodies separated by intervertebral spinal discs normally formed of a nucleus and annulus, and performing a therapy, the apparatus comprising: means for exposing an posterior sacral position of an posterior sacral vertebral body; bore forming means operable from the exposed posterior sacral position for boring a trans-sacral axial bore cephalad and axially through or into at least one cephalad vertebral body and intervertebral disc; and means for performing a therapeutic procedure in one of a vertebral body or spinal disc located within a human lumbar and sacral spine accessed through the trans-sacral axial bore.

Claim 106

Dependent Claim 114 words

95 . Apparatus for obtaining access to a series of adjacent vertebral bodies located within a human spine, the vertebral bodies separated by intervertebral spinal discs normally formed of a nucleus and annulus, and performing a therapy, the apparatus comprising: means for exposing an posterior sacral position of an posterior sacral vertebral body; bore forming means operable from the exposed posterior sacral position for boring a trans-sacral axial bore cephalad and axially through or into at least one cephalad vertebral body and intervertebral disc; and means for performing a therapeutic procedure in one of a vertebral body or spinal disc located within a human lumbar and sacral spine accessed through the trans-sacral axial bore.

Claim 107

Dependent Claim 59 words

96 . The apparatus of claim 95 , wherein the bore forming means comprises means for boring a curved posterior axial bore aligned with a posterior axial instrumentation/fusion line cephalad through the vertebral bodies of said series of adjacent vertebrae and any intervertebral spinal discs, the axial bore having a bore curvature in the posterior-anterior plane of the spine.

Claim 108

Dependent Claim 49 words

97 . The apparatus of claim 95 , wherein the means for performing a therapeutic procedure comprises an axial spinal implant adapted to be implanted into the axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body.

Claim 109

Dependent Claim 49 words

98 . The apparatus of claim 95 , wherein the means for performing a therapeutic procedure comprises an axial spinal implant adapted to be implanted into the axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body.

Claim 110

Dependent Claim 28 words

99 . The apparatus of claim 95 , wherein the means for performing a therapeutic procedure comprises means for implanting a bone growth material into the axial bore.

Claim 111

Dependent Claim 109 words

100 . The apparatus of claim 95 , wherein: the bore forming means comprises means for boring the axial bore through a caudal vertebral body, an intervertebral spinal disc, and into a cephalad vertebral body, whereby the axial bore traverses the spinal disc; and the means for performing a therapeutic procedure comprises: an axial spinal implant adapted to be implanted into the axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body and through any intervertebral spinal discs; and a bone growth material adapted to be introducing into the axial bore along with the axial spinal implant.

Claim 112

Dependent Claim 29 words

101 . The apparatus of claim 95 , wherein the means for performing a therapeutic procedure comprises means for performing disc augmentation of at least one intervertebral spinal disc.

Claim 113

Dependent Claim 107 words

102 . The apparatus of claim 101 , wherein the means for performing disc augmentation comprises: a disc augmentation catheter having a catheter body and catheter lumen extending between a catheter proximal end and a catheter distal end, the catheter distal end adapted to be advanced through the axial bore and laterally into or adjacent to the interior of a spinal disc body traversed and exposed by the axial bore; and a disc augmentation material delivery means coupled to the catheter proximal end for delivery of disc augmentation materials through said catheter lumen and from said catheter distal end and into the interior of the disc body.

Claim 114

Dependent Claim 96 words

103 . The apparatus of claim 95 , wherein: the bore forming means comprises means for boring the axial bore through a caudal vertebral body and making an axial disc opening into an intervertebral spinal disc; and the means for performing a therapeutic procedure comprises: means for performing a partial discectomy through the axial bore and the disc opening to remove at least a portion of the nucleus leaving a disc cavity enclosed by the annulus; and at least one augmentation device or material adapted to be inserted through said disc opening into the disc cavity.

Claim 115

Dependent Claim 76 words

104 . The apparatus of claim 95 , wherein: the bore forming means comprises means for boring the axial bore through a caudal vertebral body and making an axial disc opening into an intervertebral spinal disc; and the means for performing a therapeutic procedure comprises means for performing a complete discectomy through the axial bore and the disc opening to remove substantially all of the nucleus and annulus of the spinal disc leaving a disc space.

Claim 116

Dependent Claim 42 words

105 . The apparatus of claim 104 , wherein the means for performing a therapeutic procedure further comprises a spinal disc implant replacement device or material adapted to be inserted through the axial bore and the disc opening into the disc space.

Claim 117

Dependent Claim 158 words

106 . The apparatus of claim 95 , wherein: the bore forming means comprises means for boring the axial bore through a caudal vertebral body, an intervertebral spinal disc, and into a cephalad vertebral body, whereby the axial bore traverses the spinal disc; and the means for performing a therapeutic procedure comprises: means for performing a discectomy through the axial bore and the disc opening to remove at least a portion of the nucleus leaving a disc cavity within the annulus; a spinal disc implant device or material adapted to be inserted through the axial bore and into the disc cavity and having a through-hole adapted to be aligned with the axial bore; and an axial spinal implant adapted to be implanted into the axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body and through the through-hole of the spinal disc implant device or material.

Claim 118

Dependent Claim 161 words

107 . The apparatus of claim 95 , wherein: the bore forming means comprises means for boring the axial bore through a caudal vertebral body, an intervertebral spinal disc, and into a cephalad vertebral body, whereby the axial bore traverses the spinal disc; and the means for performing a therapeutic procedure comprises: means for performing a discectomy through the axial bore and the disc opening to remove at least a portion of the nucleus and annulus of the spinal disc leaving a disc space; a spinal disc implant device or material adapted to be inserted through the axial bore and into the disc space and having a through-hole adapted to be aligned with the axial bore; and an axial spinal implant adapted to be implanted into the axial bore to extend cephalad through at least one caudal vertebral body and into or through at least one cephalad vertebral body and through the through-hole of the spinal disc implant device or material.

Claim 119

Dependent Claim 61 words

108 . The apparatus of claim 95 , wherein: the bore forming means comprises means for boring a trans-sacral axial bore exposing cancellous bone of a fractured vertebral body; and the means for performing a therapeutic procedure comprises means for performing a vertebroplasty of the fractured vertebral body through the axial bore to repair damage and strengthen the fractured vertebral body.

Claim 120

Dependent Claim 28 words

109 . The apparatus of claim 95 , wherein the means for performing a therapeutic procedure comprises means for applying electrical stimulation to a spinal structure of interest.

Claim 121

Dependent Claim 33 words

110 . The apparatus of claim 95 , wherein the means for performing a therapeutic procedure comprises means for delivering a drug to a spinal structure of interest through the trans-sacral axial bore.

Claim 122

Dependent Claim 41 words

111 . The apparatus of claim 95 , wherein the means for performing a therapeutic procedure comprises means for absorbing shock between at least one caudal vertebral body and at least one cephalad vertebral body from within the trans-sacral axial bore.

Claim 123

Dependent Claim 39 words

112 . The apparatus of claim 95 , wherein the means for performing a therapeutic procedure comprises means for distracting at least one caudal vertebral body and at least one cephalad vertebral body from within the trans-sacral axial bore.

Claim 124

Dependent Claim 27 words

113 . The apparatus of claim 95 , wherein the means for performing a therapeutic procedure comprises means for emitting radiation from within the trans-sacral axial bore.

Methods and apparatus for performing therapeutic procedures in the spine

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