Method and instruments for performing a percutaneous lumbar diskectomy

A method for performing a percutaneous lumbar diskectomy comprising:

• (a) laterally inserting a cannula through the patient's side above the pelvic crest to contact a chosen vertebral disc in the lumbar region;
• (b) anchoring the cannula to the disc;
• (c) cutting the disc capsule and nucleus through the cannula in the lumbar region;
• (d) removing a desired amount of disc material through the cannula;
• and
• (e) removing the cannula.

A method for performing a percutaneous lumbar diskectomy comprising:

• (a) positioning the patient in a lateral decubitus position;
• (b) anesthetizing the patient;
• (c) laterally inserting a cannula through the patient's side above the pelvic crest to contact a chosen vertebral disc in the lumbar region;
• (d) anchoring the cannula to the disc;
• (e) cutting the disc capsule and nucleus through the cannula;
• (f) removing a desired amount of disc nucleus through the cannula;
• (g) irrigating the disc nucleus with fluid to clean it;
• (h) suctioning out the fluid;
• and
• (i) removing the cannula.

A cannula comprising:

• (a) a tubular member having a lumen;
• (b) anchor means attached to at least one end of the member for anchoring the cannula in tissue, thereby preventing shearing movement between the member and the tissue;
• (c) removable fastening means on the member for retaining the anchor means;
• and
• (d) apertures defined in the member for reception of the anchor means;
• wherein
• the anchor means is at least one anchor wire extending axially from said at least one end of the member, said anchor wire being slidably inserted into the apertures and attached to the cannula by the fastening means.

A trocar for performing a percutaneous lumbar diskectomy comprising:

• (a) a shaft having a tapered operating end for percutaneous insertion into the body, a held end, and an outer circumferential surface for slidable insertion of the operating end into a cannula;
• and
• (b) one or more slots extending axially along the outer circumferential surface for reception of protuberances on the inner surface of a cannula lumen, wherein:
• (a) the tapered operating end has a tip for anchoring the trocar in spinal disc tissues;
• and
• (b) the shaft has an adjustable collar for establishing the length that the trocar is inserted into a cannula.

An apparatus for percutaneously accessing a patient's internal body tissue comprising:

• (a) a speculum having blades for creating a percutaneous body channel;
• and
• (b) a cannula for insertion into the percutaneous body channel between the speculum blades, the cannula having:
• (i) a tubular member having a lumen for passage of medical instruments therethrough, and
• (ii) anchor means for anchoring the cannula in tissue, thereby preventing shearing movement between the member and the tissue.

An apparatus for percutaneously accessing a patient's internal body tissue comprising:

• (a) a speculum having blades for creating a percutaneous body channel;
• (b) a cannula for insertion into the percutaneous body channel between the speculum blades, the cannula having:
• (i) a tubular member having a lumen for passage of medical instruments therethrough, and
• (ii) anchor means for anchoring the cannula in tissue, thereby preventing shearing movement between the member and the tissue;
• and
• (c) a trocar for insertion of the cannula between the speculum blades, the trocar being slidably inserted into the cannula, the trocar having:
• (i) a shaft having a tapered operating end for insertion into the percutaneous channel, and
• (ii) a tip on the tapered operating end for anchoring the trocar in body tissue.

An apparatus for percutaneously accessing a patient's internal body tissue comprising:

• (a) a speculum having blades for creating a percutaneous body channel;
• (b) a cannula for insertion into the percutaneous body channel between the speculum blades, the cannula having:
• (i) a tubular member having a lumen for passage of medical instruments therethrough, and
• (ii) anchor means for anchoring the cannula in tissue, thereby preventing shearing movement between the member and the tissue;
• and
• (c) a trocar for insertion of the cannula between the speculum blades, the trocar being slidably inserted into the cannula, the trocar having:
• (i) a shaft having a tapered operating end for insertion into the percutaneous channel;
• and
• (ii) a tip on the tapered operating end for anchoring the trocar in body tissue;
• wherein:
• (d) the cannula member has an oval cross section and aperatures for reception of the anchor means;
• (e) the cannula anchor means is one or more anchor wires for slidable insertion into the member apertures;
• and
• (f) the trocar has an adjustable collar for establishing the length that the trocar is slidably inserted into the cannula.