# US 12,004,960 B2 · Method and apparatus for minimally invasive insertion of intervertebral implants

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- Number: US 12,004,960 B2
- Document ID: US12004960B2
- Status: Granted
- Kind: B2
- Application number: 17/134,642
- Filed: 2020-12-28
- Published: 2021-04-22
- Granted: 2024-06-11
- Earliest claimed: 2013-03-11
- Assignees: DePuy Synthes Products, Inc.
- Applicants: DePuy Synthes Products, Inc.
- Inventors: Rudolf Morgenstern Lopez
- Web page: https://patentgrep.com/patent/US12004960B2

## CPC

- A61F 2/4455: {for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages (intervertebral discs A61F2/442)}
- A61B 5/4893: {Nerves}
- A61B 5/6848: {Needles}
- A61B 17/1615: {Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material}
- A61B 17/1671: {for the spine}
- A61B 17/1757: {for the spine}
- A61B 17/3468: {for implanting or removing devices, e.g. prostheses, implants, seeds, wires (devices for implanting seeds A61M37/0069)}
- A61F 2/447: {substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section}
- A61F 2/4611: {of spinal prostheses}
- A61B 2017/3445: {used as instrument channel for multiple instruments}
- A61F 2/4603: {for insertion or extraction of endoprosthetic joints or of accessories thereof}
- A61F 2002/30281: {wedge-shaped}
- A61F 2002/30387: {Dovetail connection}
- A61F 2002/30398: {Sliding}
- A61F 2002/304: {with additional means for limiting said sliding}
- A61F 2002/30411: {having two threaded end parts connected by a threaded central part with opposite threads at its opposite ends, i.e. for adjusting the distance between both end parts by rotating the central part}
- A61F 2002/305: {Snap connection}
- A61F 2002/30556: {for adjusting thickness}
- A61F 2002/30579: {with mechanically expandable devices, e.g. fixation devices}
- A61F 2002/30677: {Means for introducing or releasing pharmaceutical products, e.g. antibiotics, into the body}
- A61F 2002/30785: {parallel}
- A61F 2002/30808: {parallel}
- A61F 2002/30904: {serrated profile, i.e. saw-toothed}
- A61F 2002/3093: {for promoting ingrowth of bone tissue}
- A61F 2002/4677: {using a guide wire}
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A dilation introducer for orthopedic surgery is provided for minimally invasive access for insertion of an intervertebral implant. The dilation introducer may be used to provide an access position through Kambin's triangle from a posterolateral approach. A first dilator tube with a first longitudinal axis is provided. An access cannula may be introduced over the first dilator tube. A drill may be inserted through the access cannula and used to perform a foraminoplasty, Surgical instruments may pass through the access cannula to operate on an intervertebral disc and/or insert an intervertebral implant.

## Claims

### Claim 1

A method of performing an endoscopic procedure through a Kambin's triangle of a human, the method comprising the steps of:
removing bone from a superior articular process of an inferior vertebra to enlarge the Kambin's triangle; and
inserting an intervertebral implant through the Kambin's triangle and into an intervertebral space.

### Claim 2 (depends on 1)

The method of claim 1, further comprising the step of introducing an access cannula to the Kambin's triangle toward the intervertebral space that is defined between a superior vertebra and the inferior vertebra, and the removing step comprises inserting a rotatable cutting instrument through the access cannula, and rotating the rotatable cutting instrument.

### Claim 3 (depends on 2)

The method of claim 2, wherein the inserting step comprises inserting the intervertebral implant through the access cannula and into the intervertebral space.

### Claim 4 (depends on 1)

The method of claim 1, wherein the inserting step comprises inserting the intervertebral implant in collapsed position.

### Claim 5 (depends on 4)

The method of claim 4, further comprising, after the inserting step, the step of expanding the intervertebral implant so as to cause opposed vertebral facing surfaces to bear against the respective ones of the superior and inferior vertebrae.

### Claim 6 (depends on 1)

The method as recited in claim 1, wherein the opposed vertebral facing surfaces are substantially planar.

### Claim 7 (depends on 1)

The method of claim 1, further comprising the step of driving a pedicle screw into one of the superior and inferior vertebrae.

### Claim 8 (depends on 1)

The method as recited in claim 1, further comprising the step of inserting a dilator tube along a trajectory, the trajectory extending through Kambin's triangle, and introducing the access cannula over the dilator tube.

### Claim 9 (depends on 1)

The method as recited in claim 1, further comprising the steps of introducing a guide wire into an intervertebral disc in the intervertebral space.

### Claim 10 (depends on 9)

The method as recited in claim 9, wherein the guide wire is a K-wire.

### Claim 11 (depends on 1)

The method as recited in claim 1, further comprising the step of driving an instrument through the Kambin's triangle toward the intervertebral space, and the step of inserting the dilator tube comprises inserting the dilator tube over the instrument.

### Claim 12 (depends on 11)

The method as recited in claim 11, further comprising the step of removing an attachment of the instrument prior to inserting the dilator tube over the instrument.

### Claim 13 (depends on 1)

The method as recited in claim 1, further comprising the step of sequentially dilating soft tissue with a plurality of dilator tubes, and the step of introducing an access cannula comprises inserting the access cannula over a largest one of the plurality of dilator tubes.