# US 2018/0021056 A1 · Retractor cannula system for accessing and visualizing spine and related methods

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- Number: US 2018/0021056 A1
- Document ID: US20180021056A1
- Status: Published application
- Kind: A1
- Application number: 15/477,727
- Filed: 2017-04-03
- Published: 2018-01-25
- Earliest claimed: 2008-10-20
- Assignees: Spine View, Inc.
- Applicants: Spine View, Inc.
- Inventors: John T. TO
- Web page: https://patentgrep.com/patent/US20180021056A1

## CPC

- A61B 17/3417: {Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating (syringe needles A61M5/32; dilators A61M29/00)}
- A61B 10/06: Biopsy forceps {, e.g. with cup-shaped jaws}
- A61B 1/3135: {for examination of the epidural or the spinal space}
- A61B 5/0084: {for introduction into the body, e.g. by catheters (A61B5/1459 takes precedence)}
- A61B 8/12: in body cavities or body tracts, e.g. by using catheters
- A61B 17/0218: {for minimally invasive surgery (A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)}
- A61B 90/361: {Image-producing devices, e.g. surgical cameras}
- A61B 2017/00261: {Discectomy}
- A61B 2017/003: {Steerable}
- A61B 2017/00907: {for light}
- A61B 2017/320064: {with tissue or sample retaining means}
- A61B 2017/3419: {Sealing means between cannula and body}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

Retractor cannula systems may be used for accessing and visualizing the spine and related methods of treatment, including a forward-looking retractor cannula system for creating a working space and the retractor cannula system having atraumatic dissection capability to allow visualization in spine. The devices and methods described may be used, for example, to perform annulus repair, herniated disc excision, and denervation of neurological tissue; to dispense pharmacological agents and/or cell or tissue therapy agents; to diagnose disc degeneration and bony degeneration, spinal stenosis, and nucleus decompression, and to perform disc augmentation.

## Claims

### Claim at position 1

-29. (canceled)

### Claim 30

A retractor cannula device comprising:
a first tubular body having a central axis and a distal end, the tubular body comprising at least one lumen configured to hold an endoscope;
a second tubular body slidably positioned within the first tubular body; and
a retractor assembly located at the distal end of the tubular body, the retractor assembly including at least one movable element having a distal tip, and having a first closed configuration and a second open configuration, the retractor assembly coupled to the first tubular body and the second tubular body, such that the retractor assembly transitions from the first closed configuration to the second open configuration in response to movement of the second tubular member in a distal direction, the distal tip of a first of the at least one moveable element configured to pass through the central axis of the second tubular body as the retractor assembly transitions from the first closed configuration to the second open configuration.

### Claim 31 (depends on 30)

The device of claim 30, wherein the retractor assembly is coupled to the first tubular body through a living hinge.

### Claim 32 (depends on 30)

The device of claim 30, further comprising an endoscopic system.

### Claim 33 (depends on 30)

The device of claim 30, wherein the at least one movable element comprising a curved surface.

### Claim 34 (depends on 30)

The device of claim 30, wherein the retractor assembly comprises at least two movable elements.

### Claim 35 (depends on 30)

The device of claim 30, wherein the at least one movable element comprises an optically transparent material.

### Claim 36 (depends on 30)

The device of claim 30, further comprising a handle at the proximal end of the first tubular body.

### Claim 37 (depends on 36)

The device of claim 36, wherein the handle comprises a pivot member and a device-locking mechanism.

### Claim 38 (depends on 36)

The device of claim 36, wherein the handle further comprises a pivot member configured to control the configuration of the retractor assembly and a pivot member lock configured to restrict the movement of the pivot member.

### Claim 39 (depends on 36)

The device of claim 36, wherein the handle further comprises a resistance mechanism to set the actuation force of the pivot member.

### Claim 40 (depends on 36)

The device of claim 36, wherein the handle further comprises a bias member configured to exert a bias force against the pivot member.

### Claim 41 (depends on 37)

The device of claim 37, wherein the device-locking mechanism is configured to secure an endoscopic system.

### Claim 42 (depends on 36)

The device of claim 36, wherein the handle comprises one or more ports.

### Claim 43 (depends on 42)

The device of claim 42, wherein at least one port is a visualization port in communication with the at least one lumen configured to hold the endoscopic system.

### Claim 44 (depends on 30)

The device of claim 30, wherein the at least one lumen configured to hold the endoscopic system is configured to removably receive the endoscopic system.

### Claim 45

A method for contacting and visualizing spinal tissue comprising:
advancing an introducer cannula toward a spine;
inserting an endoscope into a retractor cannula, wherein the retractor cannula comprises a tubular assembly comprising at least one lumen configured to hold an endoscope, and a retractor assembly located at the distal end of the tubular assembly,
the retractor assembly including a first element with a convex outer surface and a concave inner surface, and a second element with a convex outer surf ace and a concave inner surface, the first and second elements including an optically transparent material and at least one of the elements is pivotable with respect to the tubular assembly, and the retractor assembly further includes a first closed configuration and a second open configuration;
viewing surrounding structure through the optically transparent material of the first and second elements using the endoscope, while the retractor cannula is the in the first closed configuration; and
advancing the retractor cannula into and out of the introducer cannula in the first closed configuration.

### Claim 46 (depends on 45)

The method of claim 45, further comprising advancing an inner shaft of the tubular assembly to move the retractor assembly from the first closed configuration to the second open configuration.

### Claim 47 (depends on 45)

The method of claim 45, further comprising partially closing the retractor assembly against a target structure.

### Claim 48 (depends on 47)

The method of claim 47, further comprising:
inserting a tissue removal device into the retractor assembly; and
removing tissue from the target structure using the tissue removal device.

### Claim 49 (depends on 45)

The method of claim 45, wherein viewing surrounding structures through the optically transparent material is performed simultaneously with advancing the retractor cannula.