# US 2009/0270902 A1 · Bone dilator system and methods > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2009/0270902 A1 - Document ID: US20090270902A1 - Status: Published application - Kind: A1 - Application number: 12/490,122 - Filed: 2009-06-23 - Published: 2009-10-29 - Earliest claimed: 2003-10-23 - Assignees: TranS1 Inc. - Inventors: Robert L. Assell; Stephen D. Ainsworth; Andrew H. Cragg; Eugene A. Dickhudt - Web page: https://patentgrep.com/patent/US20090270902A1 ## CPC - A61B 17/7074: {Tools specially adapted for spinal fixation operations other than for bone removal or filler handling (A61B17/7062, A61B17/808, A61B17/8858 take precedence; for spinal image producing devices A61B90/36, A61B34/20; markers A61B90/39)} - A61B 17/025: {Joint distractors} - A61B 17/1604: {Chisels; Rongeurs; Punches; Stamps} - A61B 17/1671: {for the spine} - A61B 17/1697: {specially adapted for wire insertion} - A61B 17/1757: {for the spine} - A61B 17/8615: {at the central region of the screw head} - A61B 17/888: {the driver bit acting on the central region of the screw head} - A61B 17/8888: {at its central region} - A61B 17/0218: {for minimally invasive surgery (A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)} - A61B 17/1615: {Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material} - A61B 17/8897: {Guide wires or guide pins} - A61B 2017/00261: {Discectomy} - A61B 2017/0046: {with a releasable handle; with handle and operating part separable} - A61B 2017/00469: {for insertion of instruments, e.g. guide wire, optical fibre} - A61B 2017/0256: {for the spine} - A61B 2017/22038: {with a guide wire} - A61B 2017/22044: {with a pointed tip} - A61B 2017/3445: {used as instrument channel for multiple instruments} - A61B 2017/922: {Devices for impaction, impact element} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract Disclosed are surgical tools, tool sets and methods for percutaneously accessing and preparing treatment sites within the spine for subsequent treatment procedures. The treatment site may be an inter-vertebral motion segments in the lumbar and sacral regions of the spine. The tool set may comprise introducer tools and bone dilators for accessing and tapping into a targeted site, such as, for example, the anterior surface of the S1 vertebral body. The tool set may also comprise cutters and extractors for preparing the treatment site for subsequent treatment procedures. The tool set may additionally comprise a bone graft inserter, an exchange system, and/or a temporary distraction tool for further preparing the treatment site for subsequent treatment procedures. ## Claims ### Claim 1 A method of enlarging a bore in bone, comprising the steps of: advancing a first tubular dilator, having a first diameter, over a guide pin and into the bone; removing the first tubular dilator; and advancing at least a second tubular dilator, having a second, greater diameter, over the guide pin and into the bone. ### Claim 2 (depends on 1) A method of enlarging a bore in bone as in claim 1, wherein at least one of the advancing steps is accomplished using a cannulated slap hammer. ### Claim 3 (depends on 1) A method of enlarging a bore in bone as in claim 1, further comprising advancing a third tubular dilator over the guide pin and into the bone. ### Claim 4 A method of positioning a tubular access sheath in communication with a site in a bone, comprising the steps of: advancing a first tubular dilator, having a first diameter, over a guide pin and into the bone; removing the first tubular dilator; advancing at least a second tubular dilator, having a second, greater diameter and a removable tubular sheath, over the guide pin and into the bone; and removing the second tubular dilator, leaving the tubular sheath in position to provide access to the site in the bone. ### Claim 5 A method of using a bone dilator system, for enlarging the diameter of a bore through bone, the bone dilator system comprising: a first cannulated rod, having an outer diameter, a proximal end and a distal end; a handle on the proximal end; and a cannulated slap hammer, for reciprocal movement over a guide pin extending through the cannulated rod and slap hammer; the method comprising: inserting the first cannulated rod into the bore; and enlarging the bore by inserting a second cannulated rod into the bore, the second cannulated rod having an outer diameter greater than the outer diameter of the first cannulated rod. ### Claim 6 (depends on 5) The method of using a bone dilator system as in claim 5, the bone dilator system further comprising a guide pin. ### Claim 7 (depends on 5) The method of using a bone dilator system as in claim 5, the bone dilator system further comprising a tapered tip on the distal end. ### Claim 8 (depends on 5) The method of using a bone dilator system as in claim 5, the bone dilator system wherein the second cannulated rod, having a greater lumen diameter than the outer diameter of the first cannulated rod, is inserted over the first cannulated rod into the bore. ### Claim 9 (depends on 8) The method of using a bone dilator system as in claim 8, further comprising at least a third cannulated rod, having a greater diameter than the second cannulated rod. ### Claim 10 (depends on 8) The method of using a bone dilator system as in claim 8, further comprising a tubular sheath, wherein at least one cannulated rod is removably positionable within the tubular sheath. ### Claim 11 (depends on 10) The method of using a bone dilator system as in claim 10, further comprising a first retention structure on the sheath and a second, complementary retention structure on the at least one cannulated rod, to releasably attach the sheath to the at least one cannulated rod. ### Claim 12 A method of using a bone dilator kit, for increasing the diameter of a bore through bone, the bone dilator kit comprising: a first cannulated rod having a proximal handle and a first diameter; a second cannulated rod having a proximal handle and a second diameter; a third cannulated rod having a proximal handle and a third diameter, the first diameter being less than the second diameter, the second diameter being less than the third diameter, the method comprising: inserting the first cannulated rod into the bore to enlarge a diameter of the bore; inserting the second cannulated rod into the bore enlarged by the first cannulated rod to enlarge the diameter of the bore; and inserting the third cannulated rod into the bore enlarged by the second cannulated rod to enlarge the diameter of the bore. ### Claim 13 (depends on 12) The method of using a bone dilator kit as in claim 12, the bone dilator kit further comprising a slap hammer. ### Claim 14 (depends on 12) The method of using a bone dilator kit as in claim 12, wherein at least one of the first, second and third diameters is about 6 mm. ### Claim 15 (depends on 12) The method of using a bone dilator kit as in claim 12, wherein at least one of the first, second and third diameters is about 8 mm. ### Claim 16 (depends on 12) The method of using a bone dilator kit as in claim 12, wherein at least one of the first, second and third diameters is about 10 mm. ### Claim 17 (depends on 12) The method of using a bone dilator kit as in claim 12, the bone dilator kit further comprising a tubular sheath having a central lumen dimensioned to axially slidably receive at least one of the cannulated rods. ### Claim 18 (depends on 17) The method of using a bone dilator kit as in claim 17, the bone dilator kit further comprising a lock for releasably retaining the sheath on the at least one rod.