Abstract: A method for gaining access to and removing mechanical fasteners such as pedicle screws. A small arthroscopic incision is made over the location of the fastener. A guide wire is then placed into the incision and attached to the fastener. A series of progressively enlarging dilator tubes are slipped into the incision to progressively enlarge its diameter. A screw extractor tube is placed into the incision, over the largest dilator tube. The screw extractor tube is advanced until its lower extreme surrounds the head of the fastener. The dilator tubes are then removed. At this point, the screw extractor tube holds open the incision and provides access to the fastener through its hollow interior. A specially designed extractor tool is inserted into the screw extractor tube. An arthroscope is preferably also inserted through the screw extractor tube so that the surgeon can visualize the process. Jaws on the end of the extractor tool are clamped to the fastener's head.

Abstract: A tool for gripping and removing mechanical fasteners such as pedicle screws. With reference to FIG. 7, the device generally resembles a screwdriver, having a handle on one end, a long shaft in the middle, and fastener engaging means on the other end. The fastener engaging means comprises a set of two or more jaws having inward facing gripping surfaces positioned to grasp the external surfaces of a screw head. The jaws are formed as part of a collet slidably mounted within an outer thread sleeve. The thread sleeve is attached to the shaft. A tapered journal on the collet interacts with a tapered bore in the thread sleeve so that when the collet is pulled into the thread sleeve, the set of two or more jaws are squeezed together. The threaded engagements between the collet and the thread sleeve should be the reverse of the thread on the screw to be removed; i.e., if a right-hand screw is to be removed then the threaded engagement between the collet and the thread sleeve should be made with a left-hand thread.

Abstract: A method for gaining access to and removing mechanical fasteners such as pedicle screws. A small arthroscopic incision is made over the location of the fastener. A guide wire is then placed into the incision and attached to the fastener. A series of progressively enlarging dilator tubes are slipped into the incision to progressively enlarge its diameter. A screw extractor tube is placed into the incision, over the largest dilator tube. The screw extractor tube is advanced until its lower extreme surrounds the head of the fastener. The dilator tubes are then removed. At this point, the screw extractor tube holds open the incision and provides access to the fastener through its hollow interior. A specially designed extractor tool is inserted into the screw extractor tube. An arthroscope is preferably also inserted through the screw extractor tube so that the surgeon can visualize the process. Jaws on the end of the extractor tool are clamped to the fastener's head.

Abstract: A specially-shaped tube for gaining access to and removing mechanical fasteners such as pedicle screws. A small arthroscopic incision is made over the location of the fastener. A guide wire is then placed into the incision and attached to the fastener. A series of progressively enlarging dilator tubes are slipped into the incision to progressively enlarge its diameter. The present invention (a “screw extractor tube”), a hollow tube having a contoured upper extremity, is then placed into the incision over the largest dilator tube. The screw extractor tube is advanced until its lower extremity surrounds the head of the fastener. The dilator tubes are then removed. At this point, the screw extractor tube holds open the incision and provides access to the fastener through its hollow interior. A specially designed extractor tool is inserted into the screw extractor tube. An arthroscope is preferably also inserted through the screw extractor tube so that the surgeon can visualize the process.

Abstract: A tool for gripping and removing mechanical fasteners such as pedicle screws. With reference to FIG. 7, the device generally resembles a screwdriver, having a handle on one end, a long shaft in the middle, and fastener engaging means on the other end. The fastener engaging means comprises a set of two or more jaws having inward facing gripping surfaces positioned to grasp the external surfaces of a screw head. The jaws are formed as part of a collet slidably mounted within an outer thread sleeve. The thread sleeve is attached to the shaft. A tapered journal on the collet interacts with a tapered bore in the thread sleeve so that when the collet is pulled into the thread sleeve, the set of two or more jaws are squeezed together. The threaded engagements between the collet and the thread sleeve should be the reverse of the thread on the screw to be removed; i.e., if a right-hand screw is to be removed then the threaded engagement between the collet and the thread sleeve should be made with a left-hand thread.

Abstract: Arthroscopic cervical discectomy instruments include a push knob for a guide wire, a pair of telescopically mounted dilator tubes, one of which includes a water port so that the tube provides the additional function of an irrigation tube, a ligament cutter, a continuous suction punch, a cervical osteotone, a cervical cureet, a nucleus extractor and a cureet nucleus extractor. The dilator tubes, the ligament cutter, and the continuous suction punch are all centrally bored to receive the guide wire. All of the instruments are of arthroscopic proportions and each instrument, exclusive of its handle, is slideably insertable through the bore of the largest in diameter dilator tube. The largest in diameter dilator tube serves as a dilator, an irrigation tube, and as the main sheath through which the other tools are inserted. In a second embodiment, the pair of dilator tubes are replaced with a plurality of telescoping dilator tubes of progressively larger diameters and shorter lengths.

Abstract: A multi-function arthroscope has a laser channel, an irrigation tube, a suction tube, a rod lens, and optical fibers housed within a tubular casing. The operation site is illuminated by the optical fibers, and the physician views the illuminated site through the rod lens, performs laser surgery with laser radiation propagated by the laser channel, irrigates the site and cleans the rod lens with saline solution through the irrigation tube, and vacuums the debris with the suction tube, all in a single insertion of the arthroscope through a dilator tube. The respective distal ends of the optical fibers, rod lens, laser channel, irrigation tube, and the suction tube are positioned in different planes so that the suction tube extends in a distal direction further than the laser channel, the laser channel extends further than the irrigation tube, and the irrigation tube extends further than the rod lens.

Abstract: Arthroscopic cervical discectomy instruments include a push knob for a guide wire, a pair of telescopically mounted dilator tubes, one of which includes a water port so that the tube provides the additional function of an irrigation tube, a ligament cutter, a continuous suction punch, a cervical osteotone, a cervical cureet, a nucleus extractor and a cureet nucleus extractor. The dilator tubes, the ligament cutter, and the continuous suction punch are all centrally bored to receive the guide wire. All of the instruments are of arthroscopic proportions and each instrument, exclusive of its handle, is slidably insertable through the bore of the largest in diameter dilator tube. The largest in diameter dilator tube serves as a dilator, an irrigation tube, and as the main sheath through which the other tools are inserted.

Abstract: An arthroscopic method for debulking tissue and a kit of arthroscopic tools for performing the steps of the method. A protruding piece of tissue that is bearing against a nerve is undermined by the formation of a cavity beneath it, and the cavity is collapsed by heat generated by a laser. When the cavity collapses, the protruding tissue falls into it and separates from the nerve. The kit includes plural dilator tubes that are used to progressively dilate the arthroscopic incision and plural cutter tubes that are used in sequence to cut larger and larger pieces of tissue. Plural forceps are employed to remove the cut tissue to form the cavity, and impactor members in the kit are used to compact the bone that surrounds the cavity just before the laser is introduced into the cavity to collapse it.

Abstract: A tool that is retrofit to a conventional arthroscope to add multiple functions. The tool includes a sheath that receives the elongate tube of the arthroscope, and a lock that detachably secures the tool to the arthroscope. A hollow base member is mounted to the sheath, and a first opening formed in the sheath provides fluid communication between the hollow interior of the base member and the sheath. An irrigation control valve is mounted to the base member and supplies irrigation fluid to the site of the surgical procedure through an elongate flexible needle that extends from the irrigation control valve to the distal end of the sheath. A suction control valve has an inlet in communication with a source of negative pressure and vacuums irrigation fluid and surgical debris from the site. A laser tube intersects the sheath at a second opening at an angle and delivers coherent light to the site. Thus, the tool adds a total of three functions to the arthroscope.