SURGICAL TOOLS HAVING APPLICATION FOR SPINAL SURGICAL PROCEDURES AND METHOD OF USE
A cannula tool in combination with other tools is used to provide multiple instruments necessary for surgical procedures. The cannula tool is used in combination with a piercing tool to form a dilator instrument to access a treatment site and in combination with a plunger tool to deliver biological or grafting material to a treatment site. Each of the plunger and piercing tools includes a guide lumen to track the tools over a K-wire or other guide device for placement at the treatment site. The application discloses asymmetrical piercing and plunger tools for placement proximate to a facet joint for treatment.
The present application is a continuation of U.S. patent application Ser. No. 15/773,495, filed May 3, 2018, which is a National Phase Entry of PCT Application No. PCT/US2016/061535, filed Nov. 11, 2016, which is a continuation of U.S. patent application Ser. No. 14/941,046, filed Nov. 13, 2015, the disclosures of which are hereby incorporated by reference herein in their entireties.
BACKGROUNDMinimally invasive surgical techniques and tools have developed to treat spinal conditions such as spinal instability and deformities. Minimally invasive techniques use small incisions to access a treatment site. Such techniques reduce blood loss, postoperative pain and reduce recovery time. Dilator tubes are typically used to provide a path or conduit to a treatment site. During the course of surgery, many different instruments will be used to perform different tasks or functions. The different instruments are inserted to the treatment site using the path or conduit provided by one or more dilator tubes. Insertion of multiple instruments can complicate the surgical process and increase the time required to complete the surgical procedure.
SUMMARYThe present application relates to tools having application for minimally invasive surgery and in particular minimally invasive spinal surgery. In embodiments described, the tools include a cannula tool having an elongate tubular body forming a passage lumen extending through the elongate tubular body. The cannula tool is used with a piercing tool to open a path to a treatment site. The cannula tool includes cutting teeth to roughen and decorticate bone for the surgical procedure. In an illustrated embodiment, a decorticator tool is sized for insertion into the passage lumen of the cannula tool for use in combination with the cannula tool to remove bone. In another embodiment, the cannula tool is used with a plunger tool to form a material delivery device or instrument to inject bone fusion or grafting material for spinal fusion. In embodiments described, the cannula tool includes an interlocking element which interfaces with an interlocking element on another tool inserted into the passage lumen of the cannula tool to control and manipulate the inserted tool in combination with the cannula tool. For an illustrated surgical application, the piercing tool has an asymmetric piercing tip and the piercing and plunger tools have asymmetric guide lumens for placement proximate to a treatment site.
In an illustrated aspect, the application provides a cannula tool having an elongate tubular body forming a passage lumen having an inlet at a proximal end of the tubular body and an outlet at a distal end; and a piercing tool having an elongate cylindrical body sized for insertion into the passage lumen of cannula tool and the elongate cylindrical body and the cannula tool including interlocking elements to rotationally connect the piercing and cannula tools for insertion and the cylindrical body having a proximal end and a distal end having a piercing tip and the piercing tool including a guide lumen for insertion of the combination of the piercing tool and the cannula tool over an anchored guide wire to insert the cannula tool through the body to a treatment site.
In another aspect, the application provides an asymmetrical piercing tool formed of an elongate cylindrical body having an enlarged head at a proximal end and a distal piercing tip asymmetrically tapered to form a terminus at an outer diameter of the elongate cylindrical body and the elongate cylindrical body having an asymmetric guide lumen for insertion of the piercing tool over a guide wire to a treatment site, the guide lumen having an inlet at the proximal end and an outlet at the terminus of the asymmetrical piercing tip.
In another aspect, the application provides a surgical instrument including a cannula tool having an elongate tubular body forming a passage lumen having an inlet at a proximal end of the tubular body and an outlet at a distal end of the tubular body and a plurality of cutting teeth spaced about the passage lumen at the distal end of the tubular body and a plunger tool having an elongate cylindrical body having a proximal end and a distal end and an outer diameter sized for insertion through the passage lumen of cannula tool and the plunger tool having a guide lumen for insertion over an anchored guide wire.
In another aspect, the application provides a surgical instrument including a cannula tool having an elongate tubular body forming a passage lumen having an inlet at a proximal end of the tubular body and an outlet at a distal end of the tubular body and a plurality of cutting teeth spaced about the passage lumen at the distal end of the tubular body and a decorticator tool sized for insertion through the passage lumen of cannula tool for use in combination with the cannula tool to decorticate bone.
In another aspect, the application provides a cannula tool and piercing tool having a tapered profile to provide a means for inserting the cannula tool and piercing tool though muscle fiber to a treatment site. In an embodiment shown, the tapered profile includes a pointed or tapered piercing tip and inwardly tapered teeth on the cannula tool to provide a means for minimizing damage to muscle tissue as the cannula tool and piercing tool are inserted to the treatment site. As described, the application includes a cannula tool having a plurality of inwardly tapered teeth and a piercing tool having a tapered piercing tip and guide lumen for insertion and placement of the cannula tool at a treatment site.
This Summary is provided to introduce a selection of concepts in a simplified form that are further described below in the Detailed Description. This Summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used as an aid in determining the scope of the claimed subject matter.
Before any embodiments of the invention are explained in detail, it is to be understood that the invention is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the following drawings. The invention is capable of other embodiments and of being practiced or of being carried out in various ways. Also, it is to be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of “including,” “comprising,” or “having” and variations thereof herein is meant to encompass the items listed thereafter and equivalents thereof as well as additional items. Unless specified or limited otherwise, the terms “mounted,” “connected,” “supported,” and “coupled” and variations thereof are used broadly and encompass both direct and indirect mountings, connections, supports, and couplings. Further, “connected” and “coupled” are not restricted to physical or mechanical connections or couplings.
Spinal surgical procedures are used to correct spinal conditions and deformities. Such surgical procedures include bone fusion techniques to fuse adjacent vertebrae. The fusion process involves deployment of bone grafting material to fuse facet joints of adjacent vertebrae. During the procedure the facet bones of adjacent vertebrae are decorticated to expose the spongy bone below the cortical layer. A bone grafting material is delivered to the decorticated vertebrae to stimulate bone growth to fuse the vertebrae. In addition to the fusion process, rods are typically placed along the spine or vertebrae to stabilize the spine while the facet bones of adjacent vertebrae fuse together. Recovery from the surgery depends upon the incisions and methods used to access the spine and techniques used to stabilize and fuse the spine. Minimally invasive surgical procedures have developed for different surgeries to reduce the time in surgery as well as recovery time for the patient.
The present application relates to tools to simplify the surgical process and provide minimally invasive access and treatment for spinal conditions. The tools include a cannula tool 102 and a piercing tool 104 for placement of the cannula tool 102 at a treatment site. As illustrated in
The piercing tool 104 is formed of an elongate cylindrical body 124 having an outer diameter dimension 126 and length extending between a proximal end 128 and distal end 130. The outer diameter dimension 126 of the piercing tool 104 is sized for insertion through the passage lumen 116 of the cannula tool 102 as shown in
The piercing tool 104 is inserted into the passage lumen 116 of the cannula tool 102 as shown in
As shown in
Thereafter as shown in
With the decortication process complete, the decorticator tool 180 is removed from the cannula tool 102 and a plunger tool 185 is then inserted into passage lumen 116 of the cannula tool 102 to deliver bone grafting or other biological material to the treatment site. As diagrammatically shown in
In the embodiment shown, following deployment of the grafting or other biological material, the plunger tool 185 and the cannula tool 102 are removed for insertion of a pedicle screw 190 over the K-wire 136. As shown, the pedicle screw 190 is inserted to the treatment site over the K-wire 136. The pedicle screw 190 includes a head 192, a threaded portion 194 and an extension 196. The head 192 includes a threaded channel 198 to support a stabilizing rod of a stabilizing structure. At the treatment site, the screw 190 is threaded or tapped into the bone via a screw driver device (not shown) and the K-wire 136 is removed as illustrated in
As shown in
In an illustrated embodiment, the elongate tubular body 110 of the cannula tool 102 has a length of approximately 170 mm and an inner diameter of the elongate tubular body 110 is larger than an outer diameter of the head 192 of pedicle screw 190. In one embodiment, the elongate tubular body 110 has an inner diameter dimension of 13 millimeters (mm) and a cylindrical wall thickness of 1 mm. For placement of the pedicle screw 190, the K-wire (not shown) is anchored in the pedicle bone shown in
The elongate cylindrical body 124A has a central guide lumen 140A formed of a centered longitudinal channel that extends through the head 132A to the pointed tip 146A symmetrically aligned with the center axis of the cylindrical body 124A for insertion of the piercing tool and cannula tool 102A over the K-wire 136 as illustrated in cross-section in
As shown in
Once the debris is removed, the decorticator tool 180A is removed from the cannula tool 102A. The set screw 204 is removed via a screw driver inserted through the cannula tool. (not shown). A piggy back screw 300 is then inserted through the passage lumen 116A of cannula tool 102A for placement at the treatment site as illustrated in
In illustrated embodiments, the tools 100 are used to access, decorticate and deliver material to fuse facet joints of adjacent vertebrae. As described, the cannula tool 102 or 102A is used in combination with additional tools to provide the multiple instruments necessary for a spinal fusion procedure. In particular, as described, the piercing and cannula tools 102, 104, 102A, 104A are used to open a path to the treatment site. Once the piercing tool 104, 104A has located the treatment site the piercing tool 104, 104A is removed for use of the cannula tool 102A, 102B with other tools including the plunger and decorticator tools 180, 180A, 185 as described.
While illustrated embodiments of the tools have been described, application is not limited to the particular embodiments described. In particular, the features and tools described in the present application can be used for different applications or can be combined in different combinations as will be appreciated by those skilled in the art. Additionally although a particular handle shape or contour is shown, it should be understood that application is not limited to the particular shape and design shown. Further, although the application describes use of a K-wire, it should be appreciated by those skilled in the art that any similar guide wire device can be used to guide the tools to the treatment site.
Claims
1.-20. (canceled)
21. A surgical instrument, comprising:
- a piercing tool including a body portion defining a center axis and having a proximal end and a distal end, said body portion defining a guide lumen that defines an inlet at said proximal end and an outlet at said distal end for placement of said piercing tool over a guide wire, said guide lumen defining an open channel at an outer perimeter of said body portion, said open channel extending from said inlet to said outlet.
22. The surgical instrument of claim 21, wherein said guide lumen is configured to receive said guide wire at said inlet, said outlet, and said outer perimeter of said open channel.
23. The surgical instrument of claim 21, wherein the piercing tool is formed of an elongate cylindrical body.
24. The surgical instrument of claim 21, wherein said inlet and said outlet are coaxially aligned with said guide lumen.
25. The surgical instrument of claim 21, wherein said guide lumen is parallel to and radially offset from said center axis.
26. The surgical instrument of claim 21, wherein said piercing tool defines a tapered piercing tip at said distal end.
27. The surgical instrument of claim 26, wherein said piercing tip is asymmetrical.
28. The surgical instrument of claim 27, wherein said tapered piercing tip forms a terminus at an outer diameter of said body portion.
29. The surgical instrument of claim 28, wherein said outlet of said guide lumen is defined at said terminus.
30. The surgical instrument of claim 21, wherein the piercing tool includes an enlarged head at said proximal end, said enlarged head extending radially beyond said body portion and defining a locking aperture, said locking aperture extending adjacent said inlet and axially through said enlarged head.
31. The surgical instrument of claim 30, wherein a radial perimeter of said enlarged head is open to said locking aperture.
32. The surgical instrument of claim 31, comprising a cannula tool including:
- an elongate tubular body forming a passage lumen defining a passage inlet at a proximal end of said tubular body and a passage outlet at a distal end of said tubular body, said passage lumen being sized to receive said body portion of said piercing tool;
- a handle coupled to said elongate tubular body; and
- a locking pin that extends in an axial direction from said handle,
- wherein said locking pin is configured to engage said locking aperture of said piercing tool when said piercing tool is inserted into said cannula tool.
33. The surgical instrument of claim 32, wherein said handle extends radially outward from said center axis.
34. The surgical instrument of claim 32, wherein said locking pin extends proximally in said axial direction.
Type: Application
Filed: Mar 22, 2021
Publication Date: Sep 9, 2021
Inventor: Hamid R. Abbasi (Edina, MN)
Application Number: 17/208,752