Patent US20030199871A1 successfully refreshed from Google Patents.
US20030199871A1
Expired / Lapsed
US
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Methods and instruments for endoscopic interbody surgical techniques
Assignee: Individual
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Filing: 2003-06-05
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Granted: —
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Expires: 2023-06-05
Abstract
Abstract This invention relates to methods and instruments for performing a surgical procedure in a disc space between adjacent vertebrae. A cannula is inserted to create a working channel through the skin and tissue of a patient using a transforaminal approach to the disc space. A viewing element is used to visualize working end of the cannula and the disc space. A facetectomy is performed through the working channel to access the disc space. The disc space is prepared with various instruments, such as distractors, shims, chisels and distractor-cutters that extend through the working channel. At least implant is inserted into the disc space. The procedure allows bi-lateral support of the adjacent vertebrae with the at least one implant inserted via a unitary, minimally invasive approach to disc space.
Inventors
- 👤 Kevin Foley
- 👤 John White
- 👤 Bradley Estes
- 👤 Mingyan Liu
- 👤 Loic Josse
- 👤 Jeffrey Moore
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 18:55
CPC Classifications
A; A61; A61B; A61B17/00; A61B17/02; A61B17/025; A61B1/00; A61B1/00064; A61B1/00105; A61B17/16; A61B17/1604; A61B17/1662; A61B17/1671; A61F; A61F2/00; A61F2/02; A61F2/30; A61F2/46; A61F2/4603; A61F2/4611; A61B1/313; A61B1/3135; A61B17/00234; A61B2017/0256; A61F2/44; A61F2/442; A61F2/4455; A61F2/28; A61F2002/2835; A61F2002/30001; A61F2002/30108; A61F2002/3011; A61F2002/30112; A61F2002/30113; A61F2002/30115; A61F2002/30138; A61F2002/30153; A61F2002/30316; A61F2002/30535; A61F2002/30593; A61F2/30767; A61F2/30771; A61F2002/30772; A61F2002/30774; A61F2002/30784; A61F2002/30785; A61F2002/30787; A61F2002/448; A61F2002/4629; A61F2002/4635; A61F2/4657; A61F2002/4662; A61F2002/4681; A61F2230/00; A61F2230/0002; A61F2230/0004; A61F2230/0006; A61F2230/0017; A61F2230/0019
Claims Analysis
Total Claims: 39
Claim 1
Independent Claim
94 words
1 . A method of restoring disc height between adjacent vertebrae of a patient, the method comprising: inserting a cannula through the skin and tissue of the patient to create a working channel to the disc space; distracting the disc space to a disc space height with a distractor extending through the working channel into the disc space; inserting an instrument through the working channel; positioning a distal portion of the instrument adjacent a distal portion of the distractor in the disc space; and performing a procedure in the disc space with the instrument.
Claim 2
Dependent Claim
94 words
1 . A method of restoring disc height between adjacent vertebrae of a patient, the method comprising: inserting a cannula through the skin and tissue of the patient to create a working channel to the disc space; distracting the disc space to a disc space height with a distractor extending through the working channel into the disc space; inserting an instrument through the working channel; positioning a distal portion of the instrument adjacent a distal portion of the distractor in the disc space; and performing a procedure in the disc space with the instrument.
Claim 3
Dependent Claim
68 words
2 . The method according to claim 1 , wherein inserting the instrument includes inserting a shim through the working channel, the shim having a distal blade with a height corresponding to the distracted disc space height; and positioning the distal portion of the instrument in the disc space includes positioning the blade of the shim adjacent the distractor, the blade contacting the endplates of the adjacent vertebrae.
Claim 4
Dependent Claim
31 words
3 . The method according to claim 2 , further comprising: removing the distractor from the disc space; and maintaining the distracted disc space height with the blade of the shim.
Claim 5
Dependent Claim
24 words
4 . The method according to claim 3 , further comprising performing procedures in the disc space with the blade in the disc space.
Claim 6
Dependent Claim
77 words
5 . The method according to claim 2 , further comprising: removing the distractor from the disc space after inserting the shim; inserting a second distractor through the working channel into the disc space to increase the disc space height; removing the shim from the disc space after inserting the second distractor; and inserting a second shim through the working channel, the second shim having a blade with a height corresponding to the increased disc space height.
Claim 7
Dependent Claim
35 words
6 . The method according to claim 2 , wherein inserting the shim includes driving the shim into the disc space with a driver position about a shaft extending from the blade of the shim.
Claim 8
Dependent Claim
25 words
7 . The method according to claim 6 , wherein the shaft of the shim is bendable to clear the working channel of the cannula.
Claim 9
Dependent Claim
22 words
8 . The method according to claim 1 , wherein distracting the adjacent vertebrae includes rotating the distractor in the disc space.
Claim 10
Dependent Claim
23 words
9 . The method according to claim 1 , further comprising inserting optics through the working channel to directly visualize the disc space.
Claim 11
Dependent Claim
25 words
10 . The method according to claim 1 , wherein performing the procedure includes removing disc material from the disc space through the working channel.
Claim 12
Dependent Claim
25 words
11 . The method according to claim 1 , wherein performing the procedure includes removing endplate material from the disc space through the working channel.
Claim 13
Dependent Claim
24 words
12 . The method according to claim 1 , further comprising inserting at least one implant through the working channel into the disc space.
Claim 14
Dependent Claim
24 words
13 . The method according to claim 12 , wherein the at least one implant is inserted under direct vision from the viewing element.
Claim 15
Dependent Claim
64 words
14 . The method according to claim 1 , further comprising: inserting a guidewire into a patient through the skin and tissue to the disc space; inserting a cannulated dilator over the guidewire and through the skin and tissue to the disc space; inserting the cannula over the dilator; removing the guidewire after inserting the dilator; and removing the dilator after inserting the cannula.
Claim 16
Dependent Claim
26 words
15 . The method according to claim 1 , wherein distracting the disc space includes sequentially distracting the disc space to the desired disc space height.
Claim 17
Dependent Claim
149 words
16 . A method of preparing a disc space for insertion of an implant between adjacent vertebral endplates of a patient, the method comprising: inserting a cannula through the skin and tissue of the patient to create a working channel to the disc space; distracting the disc space to a disc space height by positioning a distractor in the disc space, the distractor being attached to a stem that extends through the working channel, the distractor including a body portion extending between a leading end and a trailing end, the body portion including an upper surface for contacting one of the adjacent vertebral endplate and an opposite lower surface for contacting the other of the adjacent vertebral endplates and opposite first and second sidewalls extending between the upper and lower surfaces; and cutting the adjacent vertebral endplates to form an implant insertion location while maintaining distraction with the distractor.
Claim 18
Dependent Claim
149 words
16 . A method of preparing a disc space for insertion of an implant between adjacent vertebral endplates of a patient, the method comprising: inserting a cannula through the skin and tissue of the patient to create a working channel to the disc space; distracting the disc space to a disc space height by positioning a distractor in the disc space, the distractor being attached to a stem that extends through the working channel, the distractor including a body portion extending between a leading end and a trailing end, the body portion including an upper surface for contacting one of the adjacent vertebral endplate and an opposite lower surface for contacting the other of the adjacent vertebral endplates and opposite first and second sidewalls extending between the upper and lower surfaces; and cutting the adjacent vertebral endplates to form an implant insertion location while maintaining distraction with the distractor.
Claim 19
Dependent Claim
56 words
17 . The method according to claim 16 , wherein the distractor includes a first flange and a second flange each extending proximally from the leading end of the body portion towards the trailing end, the first flange forming a slot with the first sidewall and the second flange forming a slot with the second sidewall.
Claim 20
Dependent Claim
45 words
18 . The method according to claim 17 , further comprising providing a cutter including an upper member with an upper cutting edge and a lower member with a lower cutting edge and a pair of opposite sidewalls extending between the upper and lower members.
Claim 21
Dependent Claim
42 words
19 . The method according to claim 18 , wherein cutting the adjacent vertebral endplates includes advancing the cutter over the body portion of the distractor such that each sidewall of the cutter is received in a respective one of the slots.
Claim 22
Dependent Claim
32 words
20 . The method according to claim 19 , further comprising: removing the distractor and cutter from the working channel; and inserting the implant into the disc space through the working channel.
Claim 23
Dependent Claim
23 words
21 . The method according to claim 16 , further comprising inserting optics through the working channel to directly visualize the disc space.
Claim 24
Dependent Claim
27 words
22 . The method according to claim 16 , wherein cutting the adjacent. vertebral endplates includes removing endplate material from the disc space through the working channel.
Claim 25
Dependent Claim
24 words
23 . The method according to claim 16 , further comprising inserting at least one implant through the working channel into the disc space.
Claim 26
Dependent Claim
24 words
24 . The method according to claim 23 , wherein the at least one implant is inserted under direct vision from the viewing element.
Claim 27
Dependent Claim
64 words
25 . The method according to claim 16 , further comprising: inserting a guidewire into a patient through the skin and tissue to the disc space; inserting a cannulated dilator over the guidewire and through the skin and tissue to the disc space; inserting the cannula over the dilator; removing the guidewire after inserting the dilator; and removing the dilator after inserting the cannula.
Claim 28
Dependent Claim
26 words
26 . The method according to claim 16 , wherein distracting the disc space includes sequentially distracting the disc space to the desired disc space height.
Claim 29
Dependent Claim
48 words
27 . The method according to claim 16 , wherein inserting the cannula includes inserting the cannula to provide a transforaminal approach to the disc space, and further comprising inserting at least one implant in the implant insertion location to provide bi-lateral support of the adjacent vertebral endplates.
Claim 30
Dependent Claim
100 words
28 . A method for inserting at least one interbody fusion device in a disc space between adjacent vertebrae, comprising: creating a working channel to the disc space by placing a cannula through the skin and tissue of a patient using a transforaminal approach to the disc space; preparing the disc space through the working channel for bi-lateral placement of the at least one interbody fusion device; and inserting the at least one interbody fusion device into the disc space through the working channel so that the adjacent vertebrae are bi-laterally supported by the at least one interbody fusion device.
Claim 31
Dependent Claim
100 words
28 . A method for inserting at least one interbody fusion device in a disc space between adjacent vertebrae, comprising: creating a working channel to the disc space by placing a cannula through the skin and tissue of a patient using a transforaminal approach to the disc space; preparing the disc space through the working channel for bi-lateral placement of the at least one interbody fusion device; and inserting the at least one interbody fusion device into the disc space through the working channel so that the adjacent vertebrae are bi-laterally supported by the at least one interbody fusion device.
Claim 32
Dependent Claim
37 words
29 . The method according to claim 28 , further comprising inserting a viewing element through the working channel; and preparing the disc space includes preparing the disc space with the viewing element in the working channel.
Claim 33
Dependent Claim
29 words
30 . The method according to claim 29 , wherein inserting the viewing element includes inserting the viewing element into the working channel to directly visualize the disc space.
Claim 34
Dependent Claim
58 words
31 . The method according to claim 28 , wherein creating a working channel includes: inserting a first dilator through the skin and tissue of the patient; sequentially inserting at least one more dilator over the first dilator; inserting the cannula over the last inserted dilator; and removing the dilators so that the cannula defines the working channel.
Claim 35
Dependent Claim
19 words
32 . The method according to claim 31 , further comprising connecting the cannula to a table based arm.
Claim 36
Dependent Claim
48 words
33 . The method according to claim 28 , wherein inserting at least one interbody fusion device comprises inserting a first interbody fusion device at a first bi-lateral location in the disc space and inserting a second interbody fusion at a second bi-lateral location in the disc space.
Claim 37
Dependent Claim
38 words
34 . The method according to claim 28 , wherein preparing the disc space includes inserting a chisel in the disc space, the chisel having upper and lower cutting edges to remove a portion of the vertebral endplates.
Claim 38
Dependent Claim
21 words
35 . The method according to claim 34 , wherein the chisel has a curved shaft defining a curvilinear cutting path.
Claim 39
Dependent Claim
29 words
36 . The method according to claim 28 , wherein preparing the disc space includes inserting a shim through the working channel to maintain distraction of the disc space.
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