# US 2023/0056904 A1 · Multiple spinal surgical pathways systems and methods > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2023/0056904 A1 - Document ID: US20230056904A1 - Status: Published application - Kind: A1 - Application number: 17/979,910 - Filed: 2022-11-03 - Published: 2023-02-23 - Earliest claimed: 2014-07-07 - Assignees: Warsaw Orthopedic, Inc. - Applicants: Warsaw Orthopedic, Inc. - Inventors: Jeffrey W. Beale; Thomas A. Carls; Richard A. Hynes; Matthew M. Morrison - Web page: https://patentgrep.com/patent/US20230056904A1 ## CPC - A61B 17/88: {Osteosynthesis instruments;} Methods or means for implanting or extracting internal {or external} fixation devices {(A61B17/7074 takes precedence)} - A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)} - A61B 17/0218: {for minimally invasive surgery (A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)} - A61B 17/025: {Joint distractors} - A61B 17/3468: {for implanting or removing devices, e.g. prostheses, implants, seeds, wires (devices for implanting seeds A61M37/0069)} - A61B 17/56: Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor - A61B 17/70: Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant - 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)} - A61B 2017/0256: {for the spine} - A61B 2017/564: {Methods for bone or joint treatment} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - 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) ## Abstract A method facilitates the treatment of the spine of a patient by providing simultaneous access through at least a first opening and a second opening formed in the patient. For example, the method can include the acts of positioning the patient on a surgical table, providing the first opening into a posterior portion of the patient, providing the second opening into a lateral portion of the patient, inserting a first device through the first opening into the patient to contact the spine in a first direction that is transverse to the coronal plane of the patient, and inserting a second device through the second opening into the patient to contact the spine in a second direction that is transverse to the sagittal plane of the patient, where the first and second openings are accessible simultaneously, and, when the first and second devises are inserted into the patient, the position of the patient is stationary with respect to a portion of the table. ## Claims ### Claim 1 A method for surgically treating the spine of a patient, the method comprising: positioning a patient on a surgical table; providing a first opening into a lateral portion of the patient; providing a second opening into a first posterior portion of the patient; providing a third opening into a second posterior portion of the patient; inserting a first bone screw through the first opening into the patient in a first direction that is transverse to the sagittal plane of the patient to fixedly engage a first vertebral body; inserting a second bone screw through the second opening into the patient in a second direction that is transverse to both of the sagittal plane and the coronal place of the patient to fixedly engage the first vertebral body; and inserting a third bone screw through the third opening into the patient in a third direction that is transverse to both of the sagittal plane and the coronal plane of the patient to fixedly engage the first vertebral body; wherein, after engagement of the second bone screw to the first vertebral body, a tip of the second bone screw is positioned one of above or below the first bone screw, and wherein, after engagement of the third bone screw to the first vertebral body, a tip of the third bone screw is positioned the other of above and below the second bone screw. ### Claim 2 (depends on 1) The method of claim 1, further comprising simultaneously accessing the first opening, and one of the second opening and the third opening. ### Claim 3 (depends on 2) The method of claim 2, further comprising simultaneously accessing the first opening, the second opening, and the third opening. ### Claim 4 (depends on 2) The method of claim 2, further comprising maintaining the patient stationary with respect to a portion of the table when the first bone screw and at least one of the second bone screw and the third bone screw are inserted into the patient. ### Claim 5 (depends on 1) The method of claim 1, further comprising contacting one of the second bone screw and the third bone screw to the first bone screw. ### Claim 6 (depends on 5) The method of claim 5, further comprising contacting the other of the second bone screw and the third bone screw to the first bone screw. ### Claim 7 (depends on 1) The method of claim 1, further comprising locating the second opening on a first side of the sagittal plane, and locating the third opening on a second side of the sagittal plane of the patient. ### Claim 8 (depends on 1) The method of claim 1, further comprising locating the second opening on one side of the spinous process of the first vertebral body, and locating the third opening on the other side of the spinous process of the first vertebral body. ### Claim 9 A method for surgically treating the spine of a patient, the method comprising: positioning a patient on a surgical table; providing a first opening into a lateral portion of the patient; providing a second opening into a first posterior portion of the patient; providing a third opening into a second posterior portion of the patient; providing a fourth opening into a third posterior portion of the patient; inserting a spinal implant through the first opening into the patient in a first direction that is transverse to the sagittal plane of the patient into a disc space between a first vertebral body and a second vertebral body; inserting a first bone screw through the second opening into the patient in a second direction that is transverse to both of the sagittal plane and the coronal place of the patient to fixedly engage the first vertebral body; inserting a second bone screw through the third opening into the patient in a third direction that is transverse to both of the sagittal plane and the coronal plane of the patient to fixedly engage the first vertebral body; and inserting a third bone screw through the fourth opening into the patient in a fourth direction that is transverse to both of the sagittal plane and the coronal plane of the patient to fixedly engage the second vertebral body; wherein, after engagement of the first bone screw and the second bone screw to the first vertebral body, tips of the first bone screw and the second bone screw are positioned below the spinal implant, and wherein, after engagement of the third bone screw to the second vertebral body, a tip of the third bone screw is positioned above the spinal implant. ### Claim 10 (depends on 9) The method of claim 9, further comprising simultaneously accessing the first opening, and one of the second opening, the third opening, and the fourth opening. ### Claim 11 (depends on 9) The method of claim 9, further comprising contacting one of the first bone screw, the second bone screw, and the third bone screw to the spinal implant. ### Claim 12 (depends on 11) The method of claim 11, further comprising contacting a first remaining one of the first bone screw, the second bone screw, and the third bone screw to the spinal implant. ### Claim 13 (depends on 12) The method of claim 12, further comprising contacting a second remaining one of the first bone screw, the second bone screw, and the third bone screw to the spinal implant. ### Claim 14 (depends on 9) The method of claim 9, further comprising locating the second opening on a first side of the sagittal plane, and locating the third opening on a second side of the sagittal plane of the patient. ### Claim 15 (depends on 14) The method of claim 14, further comprising locating the fourth opening on one of the first side and the second side of the sagittal plane of the patient. ### Claim 16 A method for surgically treating the spine of a patient, the method comprising: positioning a patient on a surgical table; providing a first opening into a lateral portion of the patient; providing a second opening into a first posterior portion of the patient; providing a third opening into a second posterior portion of the patient; inserting a spinal implant through the first opening into the patient in a first direction that is transverse to the sagittal plane of the patient into a disc space between a first vertebral body and a second vertebral body; inserting a first bone screw through the second opening into the patient in a second direction that is transverse to both of the sagittal plane and the coronal place of the patient to fixedly engage the first vertebral body; and inserting a second bone screw through the third opening into the patient in a third direction that is transverse to both of the sagittal plane and the coronal plane of the patient to fixedly engage the second vertebral body; wherein, after engagement of the first bone screw and the second bone screw to the first vertebral body, a tip of the first bone screw is positioned below the spinal implant, and wherein, after engagement of the second bone screw to the second vertebral body, a tip of the second bone screw is positioned above the spinal implant. ### Claim 17 (depends on 16) The method of claim 16, further comprising simultaneously accessing the first opening, and one of the second opening and the third opening. ### Claim 18 (depends on 16) The method of claim 16, further comprising contacting one of the first bone screw and the second bone screw to the spinal implant. ### Claim 19 (depends on 18) The method of claim 18, further comprising contacting the other of the first bone screw and the second bone screw to the spinal implant. ### Claim 20 (depends on 16) The method of claim 16, further comprising locating the second opening on a first side of the sagittal plane, and locating the third opening on a second side of the sagittal plane of the patient.