US 2003/0195519 A1 · Methods and instruments for interbody fusion

Abstract

A laparoscopic surgical technique is provided for preparing a site for implantation of a fusion device or implant. In accordance with one embodiment of the technique, a laparoscope is provided having an outer sleeve with distraction fingers at one end to distract the disc space. The laparoscope includes a laparoscopic port at its opposite end through which instruments and implants are inserted. The laparoscope provides a sealed working channel to the disc space, through which the disc space is distracted, the vertebral endplates and surrounding disc is reamed, and the fusion device inserted. The laparoscope is alternately engaged within bilateral locations in the disc space for insertion of a pair of fusion implants. A switching sleeve extends through the laparoscope to protect the tissue at the surgical site as the laparoscope is moved between the bilateral fusion locations.

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Claims11

Dependent claims

A driving tool assembly for implanting an interbody fusion device in the space between adjacent vertebrae, the fusion device including a body having a cylindrical outer surface interrupted by opposite non-cylindrical side walls, the outer surface having external threads defined thereon for threading into the adjacent vertebrae, said tool assembly comprising:

a driving tool including;
an elongated shaft;
a pair of opposite tongs connected to one end of said shaft, said tongs disposed apart relative to each other to receive the opposite side walls of the fusion device therebetween;
and
means for biasing said tongs together to apply a gripping force therebetween;
and
a driving tool attachment including a body having an outer surface and first and second ends, said body defining opposite non-cylindrical walls in said outer surface at said first end, said walls configured for clamping engagement between said tongs of said driving tool, and said body further defining opposite flanges extending from said second end, said opposite flanges having facing surfaces configured to engage the side walls of the fusion implant therebetween to impart a driving force from said driving tool attachment to the fusion implant when said driving tool attachment is engaged to said driving tool.

4 more elements

A method for implanting an interbody fusion device into a subject disc space, comprising the steps of:

a) percutaneously exposing the annulus of the disc in the subject disc space through an incision in the skin of the patient;
b) piercing the disc annulus to create an opening;
c) inserting a distractor through the incision and through the opening into the disc space to distract the vertebrae adjacent the subject disc space;
d) providing a laparoscope having an outer sleeve with opposite fingers at one end of the outer sleeve and a laparoscopic port engaged at the other end of the outer sleeve, the laparoscopic port having a number of seals, and the opposite fingers configured to maintain distraction of the vertebrae adjacent the subject disc space;
e) advancing the outer sleeve of the laparoscope through the incision and over the distractor, leaving the port outside the skin of the patient while inserting the opposite fingers through the opening into the disc space and with the outer sleeve contacting the disc annulus, whereby a protected channel is defined between the disc space and the laparoscopic port;
f) removing the distractor through the laparoscope;
g) advancing a reamer through the number of seals of the laparoscope and through the outer sleeve into the disc space;
h) reaming the disc space and adjacent vertebrae to create a prepared bore for the fusion implant;
i) removing the reamer from the laparoscope;
j) advancing the fusion device through the number of seals and through the outer sleeve into the prepared bore;
and
k) removing the laparoscope from the patient.

9 more elements

Dependencies are inferred from the claim text.

Description10,821 words

Summary1,265 words

#This application is a continuation-in-part of application Ser. No. 08/411,017, filed on Mar. 27, 1995, naming the same inventors and owned by the same assignee of the present application.

#The present invention relates to methods and instruments for performing an interbody fusion of a disc space between two adjacent vertebrae. Specifically, the invention concerns laparoscopic techniques and instruments to prepare a fusion site and to insert fusion devices and implants.

#The number of spinal surgeries to correct the causes of low back pain has steadily increased over the last several years. Most often, low back pain originates from damage or defects in the spinal disc between adjacent vertebrae. The disc can be herniated or can be suffering from a variety of degenerative conditions, so that in either case the anatomical function of the spinal disc is disrupted. The most prevalent surgical treatment for these types of conditions has been to fuse the two vertebrae surrounding the affected disc. In most cases, the entire disc will be removed, except for the annulus, by way of a discectomy procedure. Since the damaged disc material has been removed, something must be positioned within the intra-discal space, otherwise the space may collapse resulting in damage to the nerves extending along the spinal column.

Brief description of the drawings22 figures

#FIG. 1 is a side perspective view of a threaded fusion device having a tapered configuration to restore the normal angle of a spinal motion segment.

#FIG. 2 is a top elevational view of an implant driver for use in engaging and driving a fusion device such as the device shown in FIG. 1.

#FIG. 3 is an enlarged perspective view of the end of the implant driver shown in FIG. 2 engaged to an fusion device such as shown in FIG. 1.

Detailed description8,876 words

#In accordance with one aspect of the invention, a driving tool assembly for implanting an interbody fusion device in the space between adjacent vertebrae is provided. The fusion device including a body has a cylindrical outer surface interrupted by opposite non-cylindrical side walls, the outer surface having external threads defined thereon for threading into the adjacent vertebrae. The tool assembly comprises a driving tool including an elongated shaft and a pair of opposite tongs connected to one end of said shaft. The tongs are disposed apart relative to each other to receive the opposite side walls of the fusion device therebetween. In accordance with the invention, a driving tool attachment includes a body having an outer surface and first and second ends. The body defines opposite non-cylindrical walls in its outer surface at the first end, with the walls configured for clamping engagement between the tongs of the driving tool. The body further defines opposite flanges extending from its second end, the opposite flanges having facing surfaces configured to engage the side walls of the fusion implant therebetween to impart a driving force from said driving tool attachment to the fusion implant when the driving tool attachment is engaged to said driving tool.

#In another aspect of the invention, a method is provided for preparing a subject disc space for implantation of a fusion device or implant between adjacent vertebrae. In this technique, a laparoscope is provided that includes an outer sleeve with opposite extensions at one end of the outer sleeve and a laparoscopic port engaged at the other end of the outer sleeve, the laparoscopic port having a number of seals, with the opposite extensions configured to maintain distraction of the adjacent vertebrae.

#The preferred technique comprises the steps of making an incision in the skin of the patient aligned with the subject disc space, retracting tissue beneath the incision to expose the disc annulus; and piercing the disc annulus to create an opening. The the outer sleeve of the laparoscope is advanced through the incision, leaving the port outside the skin of the patient while inserting the opposite extensions into the disc space with the outer sleeve contacting the disc annulus. The laparoscope, and particularly, the outer sleeve, creates a protected working channel between the disc space and the laparoscopic port outside the patient.

Facts

Application

10/442,822Filed 21 May 2003

Priority

27 Mar 1995

Published

16 Oct 2003

Term ends

Not estimatedThe source records don’t support an estimate.

Classification75 codes

A61B 1/3132
For introducing through surgical openings, e.g. laparoscopes: for laparoscopy
A61B 1/3135
For introducing through surgical openings, e.g. laparoscopes: for examination of the epidural or the spinal space
A61B 17/025
For holding wounds open, e.g. retractors; Tractors: joint distractors
A61B 17/1671
For particular parts of the body: for the spine

Family

Application08/411,017Continuation in part · filed 27 Mar 1995

Application08/604,874Continuation · filed 22 Feb 1996

Application08/604,874Continuation in part · filed 22 Feb 1996

Application09/176,972Continuation · filed 22 Oct 1998

Application09/265,179Continuation · filed 9 Mar 1999

Application09/746,300Continuation · filed 21 Dec 2000

Application10/442,822Continuation · filed 21 May 2003

US 2002/0022845 A1Published application

US 5,782,919 ARelated patent

US 6,245,072 B1Related patent

US 6,595,995 B2Related patent

US 7,300,440 B2Related patent

US 2003/0195519 A1This patent

From the US filing history. Foreign family members aren’t listed.

Methods and instruments for interbody fusion

Life of this patent

Methods and instruments for interbody fusion

Life of this patent

Life of this patent

Abstract

Drawings

Drawings

Claims11

Description10,821 words

Drawings

Classification75 codes

Life of this patent

Description10,821 words