Methods and apparatus for performing therapeutic procedures in the spine

A method for performing a therapeutic procedure of an intervertebral spinal disc of a human spine, the spinal disc having a disc body comprising caudal and cephalad cartilaginous endplates adhered to the respective opposed endplates of adjacent caudal and cephalad vertebral bodies and joined together by a disc annulus and enclosing a disc nucleus, the method comprising the steps of:

• accessing one of an anterior or posterior sacral position of a sacral vertebral body;
• from the accessed sacral position, boring a curved trans-sacral axial bore cephalad and axially through at least the caudal sacral vertebra and through or into one or more cephalad vertebral bodies of said series of adjacent vertebral bodies and through or into at least one intervertebral spinal disc, thereby forming an axial disc opening;
• and
• performing a discectomy of the intervertebral spinal disc accessed by the axial bore through the axial bore and disc opening to remove all or substantially all of the disc body and leaving a disc space between the vertebral bodies or at least a portion of the nucleus and leaving a disc cavity within the annulus.

A method for providing access to and performing a discectomy and disc augmentation of at least one intervertebral spinal disc separating caudal and distal vertebral bodies located within a human spine, the method comprising the steps of:

• accessing a sacral position of a sacral vertebral body;
• from the accessed sacral position, boring a trans-sacral axial bore extending cephalad and axially through a caudal vertebral body to a spinal disc and making an axial disc opening into the nucleus of the spinal disc;
• excising at least a portion of the nucleus of a spinal disc from the interior of the spinal disc accessed by the axial bore and disc opening to form a disc cavity;
• and
• positioning an augmentation device or material through said disc opening into the disc cavity.

A method for providing access to an performing a discectomy of at least one spinal disc separating vertebral bodies located within a human spine, the method comprising the steps of:

• accessing a sacral position of a sacral vertebral body;
• from the accessed sacral position, boring a trans-sacral axial bore extending cephalad and axially through the vertebral bodies of a series of adjacent vertebral bodies and through or into at least one intervertebral spinal disc, thereby forming an axial disc opening;
• performing a discectomy through said axial bore and disc opening to remove at least a portion of both the annulus and nucleus of the disc accessed by the axial bore and leaving a disc space;
• and
• delivering a disc replacement material or device through the axial bore and into the disc space.

A method for providing access to and performing a vertebroplasty of at least one fractured vertebral body in a series of vertebral bodies located within a human spine, the method comprising the steps of:

• accessing a sacral position of a sacral vertebral body;
• from the accessed sacral position, boring a trans-sacral axial bore extending cephalad and axially through the vertebral bodies of said series of adjacent vertebral bodies and any intervertebral, spinal discs, the trans-sacral axial bore exposing cancellous bone of the fractured vertebral body;
• and
• performing a vertebroplasty of the fractured vertebral body through the axial bore to repair damage and strengthen the fractured vertebral body.

A method for providing access to and performing a balloon-assisted vertebroplasty of at least one fractured vertebral body in a series of vertebral bodies located within a human spine, the method comprising the steps of:

• accessing a sacral position of a sacral vertebral body;
• from the accessed sacral position, boring a trans-sacral axial bore extending cephalad and axially through the vertebral bodies of said series of adjacent vertebral bodies and any intervertebral, spinal discs, the trans-sacral axial bore exposing cancellous bone of the fractured vertebral body;
• and
• performing a balloon-assisted vertebroplasty of the fractured vertebral body through the axial bore to repair damage and strengthen the fractured vertebral body.