Methods Of Preparing Tissue Of A Patient To Receive An Implant

A method of preparing tissue of a patient to receive an implant with an instrument comprising a hand-held portion, a working portion movably coupled to the hand-held portion and comprising a cutting accessory, a plurality of actuators operatively coupled to the working portion, a drive mechanism coupled to the working portion, and a tracking device attached to the hand-held portion, said method comprising the steps of:

• tracking, with a navigation system, the cutting accessory relative to a virtual boundary associated with the tissue with the virtual boundary defining a volume of the tissue to be removed to form a pocket shaped to receive the implant;
• rotating, with the drive mechanism, the cutting accessory;
• and
• moving, with the actuators, the working portion relative to the hand-held portion in at least three degrees of freedom including translating the working portion relative to the hand-held portion to substantially maintain the cutting accessory in a desired relationship to a virtual boundary as the hand-held portion is manually grasped and moved during the surgical procedure to remove the volume of the tissue with the cutting accessory to form the pocket.

A method of performing a fusion procedure on a spine of a patient with an instrument having a hand-held portion, a working portion movably coupled to the hand-held portion and comprising a cutting accessory, a plurality of actuators operatively coupled to the working portion, a drive mechanism coupled to the working portion, and a tracking device of a navigation system attached to the hand-held portion, said method comprising the steps of:

• determining a position of the cutting accessory relative to a virtual boundary defining a volume of the tissue to be removed from the spine of the patient;
• rotating the cutting accessory of the drive mechanism about a rotational axis;
• and
• moving, with the actuators, the working portion relative to the hand-held portion in at least three degrees of freedom to substantially maintain the cutting accessory in a desired relationship to the virtual boundary as the hand-held portion is manually grasped and moved during the fusion procedure to remove volume of the tissue from the spine of the patient with the cutting accessory.

A method of preparing a spine of a patient for an implant using an instrument having a cutting accessory and a drive motor for rotating the cutting accessory, said method comprising the steps of:

• attaching one or more tracking devices to the patient;
• placing an access cannula through skin of the patient to provide minimally invasive access to a target volume of material of the spine;
• placing the cutting accessory into the access cannula;
• operating a tracking and control system to establish a virtual boundary that defines the target volume of material, track a position of the cutting accessory relative to the virtual boundary, and control movement of the cutting accessory;
• and
• manually grasping and moving the instrument to remove the target volume of material from the spine with the cutting accessory while the position of the cutting accessory is tracked relative to the virtual boundary so that the cutting accessory is maintained in a desired position with respect to the virtual boundary with the removed target volume of material forming a pocket adapted to receive the implant.