Minimally invasive tooling for delivery of interspinous spacer

A method of implanting an interspinous spacer in an interspinous space between adjacent interspinous processes of a patient, the method comprising:

• providing an interspinous spacer having a longitudinal dimension in an undeployed configuration for implantation;
• providing an insertion instrument having a longitudinal dimension;
• operating the insertion instrument to thereby engage with the interspinous spacer such that the longitudinal dimension of the interspinous spacer extends in the same direction as the longitudinal dimension of the insertion instrument, the insertion instrument comprising a barrel assembly with a proximal end and a distal end, the barrel assembly comprising an elongated outer tube, an inner shaft slidably received by the outer tube, and a handle assembly fixedly attached to the proximal end of the barrel assembly;
• inserting the interspinous spacer through the patient's supraspinous ligament such that the longitudinal dimension of the interspinous spacer extends along a posterior-anterior axis of the interspinous space;
• rotating a superior member and an inferior member both attached to one end of the body of the interspinous spacer from the undeployed position to a deployed position such that the superior member is positioned along lateral sides of a superior spinous process and the inferior member is positioned along lateral sides of an inferior spinous process by operation of the handle assembly;
• and
• disengaging the insertion instrument from the interspinous spacer.

A method for implanting an interspinous spacer in an interspinous space between adjacent spinous processes, the method comprising:

• inserting a cannula through the skin of the patient and through a supraspinous ligament of the patient to a location proximate to the patient's spine, the cannula comprising a rigid elongated tube with a proximal end, a distal end, and a lumen therethrough;
• and
• delivering an interspinous spacer through the cannula and into the interspinous space using one or more tools from a tool set comprising a plurality of individual tools, the individual tools selected from one of interspinous knife, ligament separating tool, interspinous reamer and interspinous gauge,
• wherein the interspinous spacer has a body with a longitudinal dimension extending along a posterior-anterior axis within the interspinous space, and
• wherein the interspinous knife comprises an elongated outer tube with a proximal end and a distal end;
• an inner tube with a proximal end and a distal end, the inner tube slidably received by the elongated outer tube and the distal end of the inner tube including a cutting element having two blades substantially arranged in an X pattern, the interspinous knife further including a depth control element configured to allow an operator to select from a plurality of pre-set cutting depths, and
• wherein the ligament separating tool comprises an elongated tube with a proximal end, a distal end, and a lumen therebetween, and a ligament separating assembly disposed proximate to the distal end of the elongated tube, and
• wherein the interspinous reamer comprises an elongated tube with a proximal end and a distal end, the distal end comprising an axial cutting element configured to cut tissue of the patient, and a flat end drill, the drill configured to remove tissue from the elongated tube, and
• wherein the interspinous gauge comprises an elongated barrel with a proximal end and a distal end, and at least one control attached to the proximal end of the elongated barrel wherein the interspinous gauge is configured to measure the distance between a first spinous process and a second spinous process of the patient through operation of the at least one control.

A method of implanting an interspinous spacer in an interspinous space located anterior of a supraspinous ligament and between superior and inferior spinous processes within a patient, comprising:

• configuring an interspinous spacer in a low profile configuration, wherein the interspinous spacer has a longitudinal axis in the low profile configuration;
• moving the interspinous spacer along an implant path in a posterior-to-anterior direction with the longitudinal axis extending along the implant path from an external position located posterior of the supraspinous ligament to an implant location located anterior of the supraspinous ligament, wherein the interspinous spacer enters the patient at a location at least proximate to a mid-line of the supraspinous ligament;
• and
• expanding the interspinous spacer to an operative configuration when the interspinous spacer is at the implant location and while the longitudinal axis extends in a posterior-to-anterior direction along the implant path such that the interspinous spacer interfaces with the superior and inferior spinous processes.

A method of implanting an interspinous spacer in an interspinous space located anterior of a supraspinous ligament and between superior and inferior spinous processes within a patient, comprising:

• configuring an interspinous spacer in a low profile configuration, wherein the interspinous spacer has a body with an anterior end and a posterior end spaced apart along an anterior-posterior axis, a superior cam lobe rotatably attached to the anterior end of the body, and an inferior cam lobe also rotatably attached to the anterior end of the body;
• moving the interspinous spacer along an implant path in a posterior-to-anterior direction from an external position located posterior of the supraspinous ligament to an implant location located anterior of the supraspinous ligament, wherein the interspinous spacer enters the patient at a location at least proximate to a mid-line of the supraspinous ligament and the anterior-posterior axis of the body extends at least generally in the same direction as the implant path while moving the interspinous spacer along the implant path;
• and
• rotating the superior and inferior cam lobes while the body is in the interspinous space such that the superior spinous process is received in the superior cam lobe and the inferior spinous process is received in the inferior cam lobe.