Unilateral biportal percutaneous surgical procedure

Claim 1

A percutaneous surgical disc procedure, comprising the steps of: a) percutaneously entering the back of the patient in a posterolateral direction with an access cannula; b) advancing said access cannula through a first percutaneously created fenestration of the annulus of the disc; c) securing a guide means to said access cannula and orienting an accessory cannula relative to the guide means to guide said accessory cannula; d) percutaneously entering the back of the patient in a posterolateral direction with said accessory cannula; e) advancing said accessory cannula through a second percutaneously created fenestration of the annulus adjacent to and on the same side of the disc as the first fenestration so that the access cannula and the accessory cannula are oriented relative to each other on the same side of the disc.

Claim 5

A method for the decompression of a herniated intervertebral disc in a human patient, comprising the steps of: a) percutaneously entering the back of the patient in a posterolateral direction with an access cannula; b) advancing said access cannula into the disc through a first percutaneously created fenestration of the annulus of the disc; c) securing a guide means to said access cannula and orienting an accessory cannula relative to the guide means to guide said accessory cannula; d) percutaneously entering the back of the patient in a posterolateral direction with said accessory cannula; e) advancing said accessory cannula into the disc through a second percutaneously created fenestration of the annulus adjacent to and on the same side of the disc as the first fenestration so that the access cannula and the accessory cannula are oriented relative to each other on the same side of the disc; f) removing nuclear material from one of the cannulae and observing the removal with an endoscope through the other cannula.

Claim 6

A method for the decompression of a herniated intervertebral disc in a human patient, comprising the steps of: a) percutaneously entering the back of the patient in a posterolateral direction with an access cannula; b) advancing said access cannula into the disc through a first percutaneously created fenestration of the annulus of the disc; c) securing a guide means to said access cannula and orienting an accessory cannula relative to the guide means to guide said accessory cannula; d) percutaneously entering the back of the patient in a posterolateral direction with said accessory cannula; e) advancing said accessory cannula into the disc through a second percutaneously created fenestration of the annulus adjacent to and on the same side of the disc as the first fenestration so that the access cannula and the accessory cannula are oriented relative to each other on the same side of the disc; f) removing nuclear material from one of the cannulae and observing the removal with an endoscope through the other cannula.

Claim 7

A method for the decompression of a herniated intervertebral disc in a human patient, comprising the steps of: a) percutaneously entering the back of the patient in a posterolateral direction with an access cannula; b) advancing said access cannula into the disc through a first percutaneously created fenestration of the annulus of the disc, said access cannula having a distal end within said disc and a proximal end projecting beyond the surface of the patient's back; c) securing a first jig means to said access cannula's proximal end, said first jig means having at least one small bore therethrough; d) sliding a guidewire through said bore and embedding said guidewire into the annulus fibrosis of said disc; e) removing said jig means from said access cannula; f) percutaneously entering the back of the patient in a posterolateral direction with an accessory cannula; g) advancing said accessory cannula, with the use of said embedded guidewire, into the nucleus of the disc through a second percutaneously created fenestration of the annulus adjacent to and on the same side of the disc as the first fenestration; h) removing nuclear material from one of the cannulae; and i) observing the removal with an endoscope through the other cannula.

Claim 8

A method for the decompression of a herniated intervertebral disc in a human patient, comprising the steps of: a) percutaneously entering the back of the patient in a posterolateral direction with an access cannula; b) advancing said access cannula into the disc through a first percutaneously created fenestration of the annulus of the disc, said access cannula having a distal end within said disc and a proximal end projecting beyond the surface of the patient's back; c) securing a first jig means to said access cannula's proximal end, said first jig means having at least one small bore therethrough; d) sliding a guidewire through said bore and embedding said guidewire into the annulus fibrosis of said disc; e) removing said jig means from said access cannula; f) percutaneously entering the back of the patient in a posterolateral direction with an accessory cannula; g) advancing said accessory cannula, with the use of said embedded guidewire, into the nucleus of the disc through a second percutaneously created fenestration of the annulus adjacent to and on the same side of the disc as the first fenestration; h) removing nuclear material from one of the cannulae; and i) observing the removal with an endoscope through the other cannula.

Claim 9

A method for the decompression of a herniated intervertebral disc in a human patient, comprising the steps of: a) percutaneously entering the back of the patient in a posterolateral direction with an access cannula; b) advancing said access cannula into the disc through a first percutaneously created fenestration of the annulus of the disc, said access cannula having a distal end within said disc and a proximal end projecting beyond the surface of the patient's back; c) securing a first jig means to said access cannula's proximal end, said first jig means having a plurality of small bores therethrough arranged with their axes parallel to one another and, when said first jig means is attached to said access cannula, spaced from and parallel to the axis of said access cannula; d) sliding a guidewire through a selected one of said bores and embedding said guidewire into the annulus fibrosis of said disc; e) removing said jig means from said access cannula; f) percutaneously entering the back of the patient in a posterolateral direction with an accessory cannula; g) advancing said accessory cannula, with the use of said embedded guidewire, into the nucleus of the disc through a second percutaneously created fenestration of the annulus adjacent to and on the same side of the disc as said access cannula; h) removing nuclear material from one of the cannulae; and i) observing the removal with an endoscope through the other cannula.

Claim 10

A method for the decompression of a herniated intervertebral disc in a human patient, comprising the steps of: a) percutaneously entering the back of the patient in a posterolateral direction with an access cannula; b) advancing said access cannula into the disc through a first percutaneously created fenestration of the annulus of the disc, said access cannula having a distal end within said disc and a proximal end projecting beyond the surface of the patient's back; c) securing a first jig means to said access cannula's proximal end, said first jig means having a plurality of small bores therethrough arranged with their axes parallel to one another and, when said first jig means is attached to said access cannula, spaced from and parallel to the axis of said access cannula; d) sliding a guidewire through a selected one of said bores and embedding said guidewire into the annulus fibrosis of said disc; e) removing said jig means from said access cannula; f) percutaneously entering the back of the patient in a posterolateral direction with an accessory cannula; g) advancing said accessory cannula, with the use of said embedded guidewire, into the nucleus of the disc through a second percutaneously created fenestration of the annulus adjacent to and on the same side of the disc as said access cannula; h) removing nuclear material from one of the cannulae; and i) observing the removal with an endoscope through the other cannula.