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US 6,520,907 B1Granted
Methods for accessing the spinal column
AssigneeSDGI Holdings, Inc.
InventorsKevin Thomas Foley, Maurice Mell Smith, John B. Clayton, Joseph Moctezuma
Life of this patent
Estimating the term…
Abstract
A method for accessing the spine includes making an incision in the skin of a patient. The skin and tissue can be dilated, and a cannula inserted through the dilated skin and tissue. The cannula includes a distal end positioned adjacent a first working space that includes paraspinous tissue. The cannula can be repositioned through the incision to a second working space adjacent the distal end of the cannula.
Claims133
A method for accessing the spine, comprising:
- making an incision in the skin of a patient;
- dilating the skin and tissue below the skin;
- inserting a cannula through the dilated skin and tissue, the cannula having a distal end positioned adjacent a first working space;
- inserting an instrument through the cannula;
- manipulating one or more neural elements with the instrument;
- and
- repositioning through the incision the distal end of the cannula to a second working space, the second working space including an area occupied by the neural elements before manipulation.
4 more elements
A method for accessing the spine, comprising:
- making an incision in the skin of a patient;
- dilating the skin and tissue below the skin through the incision;
- inserting a cannula through the dilated skin and tissue, the cannula having a distal end positioned adjacent a first working space;
- supporting a proximal end of the cannula;
- inserting a retractor through the cannula;
- retracting the tissue in the working space below the distal end of the cannula with the retractor;
- and
- repositioning through the incision the distal end of the cannula to define a second working space adjacent the distal end of the cannula.
5 more elements
A method for accessing the spine, comprising:
- making an incision in the skin of a patient;
- sequentially inserting one over another a number of dilators of increasing diameter;
- inserting a cannula through the incision over a final one of the number of dilators;
- removing the number of dilators to define a first working space adjacent a distal end of the cannula;
- and
- repositioning through the incision the distal end of the cannula to define a second working space adjacent the distal end of the cannula, wherein one of the first working space and the second working space is located in paraspinous tissue and the other of the first working space and the second working space includes bony structure.
3 more elements
A method for accessing the spine, comprising:
- making an incision in the skin of a patient;
- dilating the skin and tissue below the skin through the incision;
- inserting a cannula through the dilated skin and tissue, the cannula having a distal end positioned adjacent a first working space;
- supporting a proximal end of the cannula;
- inserting a surgical instrument through the cannula;
- manipulating the tissue in the working space with the surgical instrument;
- and
- repositioning through the incision the distal end of the cannula to define a second working space adjacent the distal end of the cannula, wherein one of the first working space and the second working space includes paraspinous tissue and the other of the first working space and the second working space includes bony structure.
5 more elements
A method for accessing the spine, comprising:
- making an incision in the skin of a patient;
- dilating the skin and tissue below the skin through the incision;
- inserting a cannula through the dilated skin and tissue, the cannula having a distal end positioned adjacent a first working space;
- supporting a proximal end of the cannula;
- inserting a surgical instrument through the cannula;
- manipulating the tissue in the working space with the surgical instrument;
- repositioning through the incision the distal end of the cannula to define a second working space adjacent the distal end of the cannula;
- and
- performing a surgical procedure through the cannula in at least one of the first working space and the second working space, wherein the surgical procedure includes retracting neural elements.
6 more elements
A method for accessing the spine, comprising:
- making an incision in the skin of a patient;
- dilating the skin and tissue below the skin through the incision;
- inserting a cannula through the dilated skin and tissue, the cannula having a distal end positioned adjacent a first working space;
- supporting a proximal end of the cannula;
- inserting a surgical instrument through the cannula;
- manipulating the tissue in the working space with the surgical instrument;
- repositioning through the incision the distal end of the cannula to define a second working space adjacent the distal end of the cannula;
- and
- performing a surgical procedure through the cannula in at least one of the first working space and the second working space, wherein the surgical procedure includes removing bone.
6 more elements
A method for accessing the spine, comprising:
- making an incision in the skin of a patient;
- dilating the skin and tissue below the skin through the incision;
- inserting a cannula through the dilated skin and tissue, the cannula having a distal end positioned adjacent a first working space;
- supporting a proximal end of the cannula;
- inserting a surgical instrument through the cannula;
- manipulating the tissue in the working space with the surgical instrument;
- repositioning through the incision the distal end of the cannula to define a second working space adjacent the distal end of the cannula;
- and
- performing a surgical procedure through the cannula in at least one of the first working space and the second working space, wherein the surgical procedure includes cutting bone.
6 more elements
A method for accessing the spine, comprising:
- making an incision in the skin of a patient;
- dilating the skin and tissue below the skin through the incision;
- inserting a cannula through the dilated skin and tissue, the cannula having a distal end positioned adjacent a first working space;
- supporting a proximal end of the cannula;
- inserting a surgical instrument through the cannula;
- manipulating the tissue in the working space with the surgical instrument;
- repositioning through the incision the distal end of the cannula to define a second working space adjacent the distal end of the cannula;
- performing a surgical procedure through the cannula in at least one of the first working space and the second working space positioning a viewing element with respect to the cannula to visualize the surgical procedure;
- and
- securing the viewing element to a proximal end of the cannula.
7 more elements
A method for accessing the spine, comprising:
- making an incision in the skin of a patient;
- inserting a guidewire through the incision into paraspinous tissue;
- sequentially inserting one over another a number of dilators of increasing diameter, the guidewire guiding at least a first one of the number of dilators through the paraspinous tissue;
- inserting a cannula through the incision over a final one of the number of dilators;
- removing the guidewire and the number of dilators to define a first working space in the paraspinous tissue adjacent a distal end of the cannula;
- repositioning through the incision the distal end of the cannula to define a second working space adjacent the distal end of the cannula;
- and
- inserting an instrument through the cannula to work adjacent the spine as the distal end of the cannula is repositioned, wherein the instrument is a retractor and the work is retracting paraspinous tissue.
5 more elements
A method for accessing the spine, comprising:
- making an incision in the skin of a patient;
- dilating the skin and tissue below the skin through the incision;
- inserting a cannula through the dilated skin and tissue, the cannula having a distal end positioned adjacent a first working space;
- supporting the proximal end of the cannula;
- positioning a viewing element with respect to the cannula to visualize the first working space;
- repositioning through the incision the distal end of the cannula to a second working space adjacent the distal end of the cannula under visualization from the viewing element;
- and
- inserting a retractor through the cannula to retract paraspinous tissue as the distal end of the cannula is repositioned.
5 more elements
A method for accessing the spine, comprising:
- making an incision in the skin of a patient;
- dilating the skin and tissue below the skin through the incision;
- inserting a cannula through the dilated skin and tissue, the cannula having a distal end positioned adjacent a first working space;
- supporting the proximal end of the cannula;
- positioning a viewing element with respect to the cannula to visualize the first working space;
- and
- repositioning through the incision the distal end of the cannula to a second working space adjacent the distal end of the cannula under visualization from the viewing element, wherein dilating the skin and tissue includes:
- sequentially inserting one over another a number of dilators of increasing diameter;
- and
- inserting the cannula through the incision over a final one of the number of dilators.
7 more elements
A method for accessing the spine, comprising:
- making an incision in the skin of a patient;
- dilating the skin and tissue below the skin;
- inserting a cannula through the dilated skin and tissue, the cannula having a distal end positioned adjacent a first working space that includes paraspinous tissue;
- repositioning through the incision the distal end of the cannula to a second working space adjacent the distal end of the cannula, the second working space including bony structure of the spine;
- and
- inserting a retractor through the cannula to retract paraspinous tissue as the distal end of the cannula is repositioned.
3 more elements
A method for accessing the spine, comprising:
- making an incision in the skin of a patient;
- dilating the skin and tissue below the skin;
- inserting a cannula through the dilated skin and tissue, the cannula having a distal end positioned adjacent a first working space that includes paraspinous tissue;
- repositioning through the incision the distal end of the cannula to a second working space adjacent the distal end of the cannula, the second working space including bony structure of the spine;
- inserting an instrument through the cannula;
- and
- manipulating a neural elements with the instrument, wherein the second working space includes an area occupied by the unmanipulated neural elements.
4 more elements
A method for accessing the spine, comprising:
- making an incision in the skin of a patient;
- dilating the skin and tissue below the skin;
- inserting a cannula through the dilated skin and tissue, the cannula having a distal end positioned adjacent a first working space that includes paraspinous tissue;
- and
- repositioning through the incision the distal end of the cannula to a second working space adjacent the distal end of the cannula, the second working space including bony structure of the spine, wherein dilating the skin and tissue includes:
- sequentially inserting one over another a number of dilators of increasing diameter;
- and
- inserting the cannula through the incision over a final one of the number of dilators.
5 more elements
Dependencies are inferred from the claim text.