# US 12,178,720 B2 · Systems and methods for Percutaneous Spinal Interbody Fusion (PSIF) > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 12,178,720 B2 - Document ID: US12178720B2 - Status: Granted - Kind: B2 - Application number: 17/583,281 - Filed: 2022-01-25 - Published: 2022-05-12 - Granted: 2024-12-31 - Earliest claimed: 2019-06-28 - Assignees: MIS Spine IP, LLC - Applicants: MIS Spine IP, LLC - Inventors: Ludwig David Orozco Castillo - Web page: https://patentgrep.com/patent/US12178720B2 ## CPC - A61F 2/4611: {of spinal prostheses} - A61B 17/0206: {with antagonistic arms as supports for retractor elements} - A61B 17/1757: {for the spine} - A61B 17/686: {Plugs, i.e. elements forming interface between bone hole and implant or fastener, e.g. screw} - A61B 17/7064: {Devices acting on, attached to, or simulating the effect of, vertebral facets; Tools therefor} - A61B 17/7086: {Rod reducers, i.e. devices providing a mechanical advantage to allow a user to force a rod into or onto an anchor head other than by means of a rod-to-bone anchor locking element; rod removers} - 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)} - A61F 2/447: {substantially parallelepipedal, e.g. having a rectangular or trapezoidal cross-section} - A61F 2/4684: {Trial or dummy prostheses} - A61M 29/00: Dilators with or without means for introducing media, e.g. remedies - A61B 17/0218: {for minimally invasive surgery (A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)} - A61B 17/144: {with cutting edges at the side of the saw blades} - A61B 17/1615: {Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material} - A61B 17/1659: {Surgical rasps, files, planes, or scrapers} - A61B 17/1671: {for the spine} - A61B 17/7032: {Screws or hooks with U-shaped head or back through which longitudinal rods pass} - A61B 17/8897: {Guide wires or guide pins} - A61B 2017/0262: {with a provision for protecting nerves} - A61B 2217/005: with suction drainage system - A61F 2/4601: {for introducing bone substitute, for implanting bone graft implants or for compacting them in the bone cavity} - A61F 2002/30405: {made by screwing complementary threads machined on the parts themselves} - A61F 2002/30507: {using a threaded locking member, e.g. a locking screw or a set screw} - A61F 2002/30538: {for adjusting angular orientation} - A61F 2002/30556: {for adjusting thickness} - A61F 2002/30593: {hollow} - A61F 2002/4625: {with relative movement between parts of the instrument during use} - A61F 2002/4627: {with linear motion along or rotating motion about the instrument axis or the implantation direction, e.g. telescopic, along a guiding rod, screwing inside the instrument} - 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) - A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)} ## Abstract The present invention includes a novel procedure and corresponding medical devices for a Purcutaneous Spinal Interbody Fusion (PSIF). In PSIF, the surgeon performs the entire operation percutaneously without the use of a microscope, endoscope, or magnifying loupes. An adjustable retractor system is disclosed that enables the surgeon to percutaneously perform the surgery through accessing the facet joint (and later disc space) that was created by said retractor system. This retractor system provides the surgeon a safe area to work and operate without fear of damaging nerves, blood vessels, or other tissue. An expanding trial may be inserted into and removed from the disc space through the interior of the retractor system to determine the proper size for the expandable cage. The retractor system also enables the expandable cage to be inserted into the disc space. ## Claims ### Claim 1 A medical device for use with a patient comprising: a shaft that is configured to be connected to a power supply and is configured to be held by a user; and a tube that is configured to be connected to said shaft, wherein said tube is connected to a tip through a connector wherein said tip has a smaller cross-sectional area than said tube; wherein said tip is configured to ultrasonically oscillate and enable said tip to break up human tissue; wherein said tube is configured to fit inside of a retractor during said oscillation of said tip, thereby limiting an oscillation of said tip to an area defined by an internal cross-section area of said retractor. ### Claim 2 (depends on 1) The medical device of claim 1 wherein said tube has an aspiration channel that is configured to enable aspiration of said human tissue. ### Claim 3 (depends on 1) The medical device of claim 1 wherein said tube and said tip have an irrigation channel that is configured to supply fluid to a patient. ### Claim 4 (depends on 1) The medical device of claim 1 wherein said tube is removably connected to said tip. ### Claim 5 (depends on 1) The medical device of claim 1 wherein at least a portion of said tip is further configured to fit inside of said retractor during said oscillation. ### Claim 6 (depends on 1) The medical device of claim 1 wherein said tube is configured to fit inside of a soft tissue retractor during said oscillation of said tip, wherein said medical device may access a facet joint of said patient through said soft tissue retractor. ### Claim 7 (depends on 1) The medical device of claim 1 wherein said tube is configured to fit inside of a disc retractor during said oscillation of said tip, wherein said medical device may access a disc space of said patient through said disc retractor. ### Claim 8 (depends on 1) The medical device of claim 1 wherein said tip further comprises a first tip portion and a second tip portion that are both configured to ultrasonically oscillate. ### Claim 9 (depends on 1) The medical device of claim 1 wherein said medical device is adjustable and is further configured to enable said user to remove a first tip and attach a second tip. ### Claim 10 A medical device for removing human tissue for use with a patient comprising: a shaft that is configured to be connected to a power supply and is configured to be held by a user; and a tube that is configured to be connected to said shaft and has a first portion and a second portion, wherein said first portion is configured to fit inside of a retractor and said second portion is configured to be connected to a tip; wherein said tip is configured to ultrasonically oscillate to break up human tissue; wherein during said oscillation, said first portion of said tube is configured to be located inside of said retractor, wherein said oscillation of said tip is defined by an internal cross-section area of said retractor. ### Claim 11 (depends on 10) The medical device of claim 10 wherein said tube has an aspiration channel that is configured to enable an aspiration of said human tissue. ### Claim 12 (depends on 10) The medical device of claim 10 wherein said tube and said tip have an irrigation channel that is configured to supply fluid to a patient. ### Claim 13 (depends on 10) The medical device of claim 10 wherein said tube is removably connected to said tip. ### Claim 14 (depends on 10) The medical device of claim 10 wherein said tube is removably connected to said shaft. ### Claim 15 (depends on 10) The medical device of claim 10 wherein said first portion of said tube is configured to fit inside of a soft tissue retractor during said oscillation of said tip, wherein said medical device may access a facet joint of said patient through said soft tissue retractor. ### Claim 16 (depends on 10) The medical device of claim 10 wherein said first portion of said tube is configured to fit inside of a disc retractor during said oscillation of said tip, wherein said medical device may access a disc space of said patient through said disc retractor. ### Claim 17 An attachment for a human tissue removal device for use with a spine of a patient comprising: a connector that is configured to be removably connected to a shaft of said removal device and is configured to fit inside of a retractor; and a tip that is configured to ultrasonically oscillate to remove human tissue and is configured to fit inside of said retractor; wherein said connector has a smaller cross-sectional area than said retractor; wherein said connector is configured to fit inside said retractor during said oscillation, thereby limiting said oscillation of said tip to an area defined by an internal cross-section area of said retractor. ### Claim 18 (depends on 17) The attachment of claim 17 wherein said connector has an aspiration channel that is configured to enable an aspiration of said human tissue. ### Claim 19 (depends on 17) The attachment of claim 17 wherein said connector has an irrigation channel that is configured to supply fluid to a patient. ### Claim 20 (depends on 17) The attachment of claim 17 wherein said connector is further configured to comprise a tube portion that is configured to be removably connected to said shaft.