Dilation introducer for orthopedic surgery
The dilation introducer has a locked assembled configuration for placement of the dilation introducer against a patient's tissue to be treated, and an unlocked, collapsed configuration for dilating the patient's soft tissue down to tissue to be treated. Dilator tubes are successively released and advanced to progressively expand the patient's soft tissue down to the bone tissue to be treated. The dilator tubes and a guide insert may include spikes for engaging bone tissue. The dilation introducer may include a light emitter disposed in a dilator tube. A telescoping expander sleeve is also provided.
This is a continuation-in-part of Ser. No. 10/911,215, filed Aug. 3, 2004.
BACKGROUND OF THE INVENTION1. Field of the Invention
This invention relates to bone fixation devices, and more particularly relates to a dilation introducer for introducing a bone fixation device for orthopedic surgery, such as for vertebral fusion.
2. General Background and State of the Art
Fusion of two adjacent vertebrae is a common surgical treatment for back injuries due to damage or defects in a spinal disc between two adjacent vertebrae, such as conditions due to a herniated disc or disc degeneration. The entire disc may be removed by a discectomy procedure, and may be replaced with bone or a bone substitute and/or cage in order to prevent collapse of the disc space between the adjacent vertebrae. Early techniques for stabilizing the adjacent vertebrae included application of a plate or a rod in conjunction with screws across the adjacent vertebrae, after which the adjacent vertebrae would eventually fuse together. However, such techniques commonly required prolonged periods of recovery from the extensive surgery involved, and it would be desirable to provide an improved apparatus and method for providing a minimally invasive procedure that will result in less trauma and improvement in patient recovery.
Bone fixation devices are known that are useful for connecting two or more bone segments for the healing of broken bones, typically including an elongate pin with a distal anchor and a proximal anchor movable on the pin to accommodate different bone dimensions, and to permit tensioning of the bone segments together. The surgical procedure of attaching two or more parts of a bone with a pin-like device commonly requires an initial incision into the tissue down to the bone, and the drilling of a hole through the bone parts to be joined. Such bone fixation devices can be useful for fusion of vertebrae together, because such a bone fixation device can be used to join adjacent bone segments through a single percutaneous incision or puncture, without the need to expose any other side of the bone segments to be joined. In either type of procedure, there is substantial trauma to the surrounding tissue if a large incision is required. Thus, it would be desirable to provide a minimally invasive dilation introducer to allow the penetration and spreading of soft tissues down to vertebrae to be fused, for use of such a bone fixation device to join adjacent vertebrae, and to allow for more easily performing the delicate maneuvering of drilling adjacent vertebrae and application of one or more bone fixation devices to join the vertebrae to be fused. The present invention satisfies these and other needs.
INVENTION SUMMARYBriefly, and in general terms, the invention provides for a telescoping dilation introducer for orthopedic surgery, the dilation introducer having a locked assembled configuration for initial placement of the dilation introducer against a patient's tissue to be treated, and an unlocked, collapsed configuration for dilating the patient's soft surrounding tissue to a desired degree of dilation to permit minimally invasive surgical procedures on the patient's tissue. As the telescoping dilation introducer is inserted, each individual dilator tube is successively released and advanced to progressively expand the patient's soft tissue down to the tissue to be treated. In a particularly useful aspect of the invention, the tissue to be treated is bone tissue which must be prepared prior to attachment of adjacent bone section in a fusion process. While there are many applications of the dilation introducer of the invention, the invention is particularly applicable to fusion of bones in orthopedic surgery using minimally invasive technique, and will be described herein in particular applications of those procedures. The invention also concerns a minimally invasive procedure utilizing the telescoping dilation introducer to insert a bone fixation device into a patient's spine for posterior spine fusion. While posterior spine fusion currently takes up to two hours to complete, and requires a six inch incision, with the apparatus and method of the invention, comparable surgery can be completed in less than thirty minutes, with a dilation port 13 mm or less in diameter, thus lowering the chance of damage to the surrounding soft tissue.
A telescoping dilation introducer is typically operated by pressing the introducer against a relatively hard surface, such as bone tissue being treated. The present invention provides for a guide wire assembly when such a telescoping dilation introducer is to used in treatment of soft tissue, such as an organ, to provide a surface against which the telescoping dilation introducer can be pushed during operation of the telescoping dilation introducer. In a presently preferred embodiment, a guide wire or K wire assembly is provided for use with a telescoping dilation introducer according to the invention. The guide wire assembly includes an elongated generally cylindrical first section, and an elongated tubular second section that receives the first section. The elongated generally cylindrical first section includes a proximal enlarged head or stop portion, and an elongated body portion with a proximal section and a relatively narrower diameter main section connected to the proximal section, and a pointed distal tip at the distal end of the narrow main section. The second section of the guide wire assembly includes an elongated tubular body with an internal bore adapted to receive the narrow main section, as is illustrated in
In one presently preferred embodiment, the present invention provides for an improvement in a dilation introducer for orthopedic surgery, in which the dilation introducer includes one or more dilator tubes having a distal end and a proximal end, and the distal end of the one or more dilator tubes including a plurality of spikes for engaging bone tissue. In one presently preferred aspect, the spikes may be formed of radiopaque material, for fluoroscopic imaging of the positioning of the one or more dilator tubes, and the spikes may be formed with a rounded shape so as to deflect soft tissue.
In another presently preferred aspect, the dilation introducer includes a parallel guide insert adapted to be received in the one or more dilator tubes. The parallel guide insert includes a main cylindrical shaft having a proximal end connected to a cylindrical head, and a plurality of longitudinal bores extending the length of the parallel guide insert through the main cylindrical shaft and cylindrical head. The distal tip of the parallel guide insert may be provided with a plurality of spikes for engaging bone tissue. The spikes of the parallel guide insert may be formed of radiopaque material, and may be formed with a rounded shape so as to deflect soft tissue.
In another presently preferred embodiment, the present invention concerns a dilation introducer for orthopedic surgery having a locked assembled configuration for initial placement of the dilation introducer against a patient's bone tissue to be treated, and an unlocked, collapsed configuration dilating the patient's soft tissue down to the bone tissue to be treated to a desired degree of dilation to permit minimally invasive surgical procedures on the patient's bone tissue to be treated. The dilation introducer includes a first dilator tube having a distal end with a tapered tip and a proximal end with a cylindrical head, and a second dilator tube having a distal end with a tapered tip and a proximal end with a cylindrical head, and an inner lumen with a distal opening and a proximal opening. The first dilator tube is removably received in the second dilator tube for slidable telescoping movement within the second dilator tube. Means are provided for removably connecting the first and second dilator tubes together in a locked configuration. The means for removably connecting the first and second dilator tubes includes a first latching member disposed in the cylindrical head of the first dilator tube. The first latching member has a locking button connected transversely to a shaft with a latching end projecting from the cylindrical head of the first dilator tube toward the distal end of the first dilator tube, with the locking button extending transversely from the shaft through a side aperture in the cylindrical head of the first dilator tube. The locking button is biased outwardly from the cylindrical head, such as by a spring, and the first latching member is received in an upper aperture of the cylindrical head of an adjacent second dilator tube. The upper aperture of the cylindrical head of the second dilator tube includes a latching chamber for retaining the latching end of the latching member when the locking button is biased outwardly, to lock the cylindrical heads of the first and second dilator tubes together. The locking button is moveable inwardly to move the latching member inwardly and to move the latching end of the latching member inwardly out of the latching chamber, to unlock the first and second dilator tubes.
The dilation introducer may include one or more additional dilator tubes, with the second dilator tube being removably received in the one or more additional dilator tubes for slidable telescoping movement within the one or more additional dilator tubes. The one or more additional dilator tubes likewise have a distal end and a proximal end with a cylindrical head, an inner lumen with a distal opening and a proximal opening, and the distal end having a tapered tip. The second dilator tube and the one or more additional dilator tubes having an unlocked configuration in which the one or more additional dilator tubes may slidably telescope over the second dilator tube to dilate the patient's soft tissue at the distal end of the dilation introducer. Means are provided for removably connecting the second dilator tube and the one or more additional dilator tubes together in a locked configuration. The means for removably connecting the second dilator tube and the one or more additional dilator tubes include a second latching member disposed in the cylindrical head of the second dilator tube. The second latching member has a locking button connected transversely to a shaft with a latching end projecting from the cylindrical head of the second dilator tube toward the distal end of the second dilator tube, and the locking button extends transversely from the shaft through a side aperture in the cylindrical head of the second dilator tube. The locking button is biased outwardly from the cylindrical head, such as by a spring, and the second latching member is received in an upper aperture of the cylindrical head of the additional dilator tube to be connected. The upper aperture of the cylindrical head of the additional dilator tubes include a latching chamber for retaining the latching end of the second latching member when the locking button is biased outwardly, to lock the cylindrical heads of the second and additional dilator tube together, and the locking button is moveable inwardly to move the second latching member inwardly and the latching end of the second latching member inwardly out of the latching chamber.
In a presently preferred aspect, the additional dilator tube comprises a handle connected to the proximal end of the additional dilator tube, and the cylindrical head of the additional dilator tube includes a plurality of the upper apertures, each including a latching chamber for receiving the second latching member.
In another presently preferred embodiment, the present invention provides for an improvement in a dilation introducer for orthopedic surgery, in which the dilation introducer includes a dilator tube having a tubular shaft, a distal end and a proximal end, an inner lumen with a distal opening and a proximal opening, and a light emitter disposed in the dilator tube. In one aspect, the light emitter may be a light emitting diode, and the light emitting diode may be embedded in the tubular shaft of the dilator tube. In another aspect, the light emitter may include a fiber optic, and the fiber optic may be embedded in the tubular shaft of the dilator tube.
In a presently preferred aspect, the dilator tube includes a handle and a switch for controlling the light emitter, and at least one battery is disposed in the handle and is connected to the switch to power the light emitter. Where the light emitter includes one or more fiber optics, the light emitter includes a light source providing light conducted to the one or more fiber optics. The light emitter may include one or more elongated energy conducting members disposed on an outer surface of the tubular shaft of the dilator tube, and the one or more elongated energy conducting members may be disposed in a groove on the exterior surface of the tubular shaft. Alternatively, the one or more elongated energy conducting members may be located on the inside of the dilator tube, or may extend through the wall of the dilator tube.
The present invention also provides for a telescoping expander sleeve adapted to be slidably disposed over a shaft of a dilator tube for dilating a patient's soft tissue down to a bone tissue to be treated to a desired degree of dilation to permit minimally invasive surgical procedures on the patient's bone tissue. The telescoping expander sleeve is moveable between an extended, unexpanded configuration and a collapsed, expanded configuration. The telescoping expander sleeve includes a first generally tubular section having a tubular proximal portion and a distal portion. The tubular proximal portion has an enlarged proximal head, and the distal portion includes two or more active spreader arms each having a proximal end and a distal tip. The tubular proximal portion may optionally be provided with a handle. The two or more active spreader arms are connected at their proximal ends to the tubular proximal portion, and the distal tips of the two or more active spreader arms are moveable radially between an unexpanded configuration and an expanded configuration.
The telescoping expander sleeve also includes a second generally tubular section slidably disposed over the first generally tubular section. The second generally tubular section includes a tubular proximal portion and a distal portion including two or more passive spreader flaps each having a narrow proximal end and a wide distal tip. The proximal ends of the two or more passive spreader flaps are hingedly connected to the tubular proximal portion, and the distal tips of the two or more passive spreader flaps are moveable radially between an unexpanded configuration and an expanded configuration. The two or more active spreader arms slidably engage the two or more passive spreader flaps, so that as the telescoping expander sleeve telescopes from the extended, unexpanded configuration to the collapsed, expanded configuration, the two or more active spreader arms slide from the narrow proximal ends of the two or more passive spreader flaps to the wider distal ends of the passive spreader flaps to spread the distal ends of the two or more passive spreader flaps apart, and to spread the distal ends of the two or more active spreader arms apart.
In a presently preferred aspect, the distal tips of the two or more active spreader arms have beveled edges to deflect soft tissue during insertion of the telescoping expander sleeve, and the distal tips of the two or more passive spreader flaps have beveled edges to deflect soft tissue during insertion of the telescoping expander sleeve. The purpose of the active spreader arms and passive spreader flaps is to facilitate the creating of a larger working area adjacent to bone or bone tissues being treated. The spreader arms and flaps may optionally be covered by an expandable material, such as latex, for example, to prevent tissues from being pressed into cavities of the telescoping expander sleeve.
While the present invention is particularly useful for the purposes of orthopedic surgery, those skilled in the art will recognize that the invention can also be used for the treatment of a variety of internal organs or structures when it is desired to minimize the size of an opening in the patient's soft tissue and the resultant damage and trauma to tissue surrounding the operation site.
Other features and advantages of the present invention will become more apparent from the following detailed description of the preferred embodiments in conjunction with the accompanying drawings, which illustrate, by way of example, the operation of the invention.
BRIEF DESCRIPTION OF THE DRAWINGS
Referring to the drawings, which are provided for purposes of illustration and by way of example, the present invention provides for a telescoping dilation introducer for orthopedic surgery, the dilation introducer having a locked assembled configuration for initial placement of the dilation introducer against a patient's bone tissue to be treated, and an unlocked, collapsed configuration dilating the patient's soft tissue down to the bone tissue to be treated to a desired degree of dilation to permit minimally invasive surgical procedures on the patient's bone tissue to be treated.
While the invention will be described with specificity to a spinal fusion procedure, those skilled in the art will recognize that the apparatus and method of the art will recognize that the apparatus and method of the invention can also be advantageously used for procedures in which the dilation introducer can be brought up against other firm or solid structures in the body or introduced into the body to thereby gain the advantages of the invention for other minimally invasive procedures.
A dilation introducer 30 according to a first preferred embodiment is shown in a locked assembled configuration in
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The second locking clip includes a first portion 122 and a second portion 124, and a cross-piece or handle 126 having a first end 128 and a second end 130 connected between the first portion and the second portion at right angles. The first portion includes a pair of resilient arms 132 each having a proximal narrow neck portion 134 connected to the cross-piece, and a distal gripping portion 136 extending from the narrow neck portion. The pair of resilient arms have an inner rounded surface 138 adapted to snap over the outer surface of the second dilator tube between the spaced apart rings of the second dilator tube. The second portion of the second locking clip includes a pair of resilient arms 142 each having a proximal narrow neck portion (not shown) connected to the cross-piece and a distal gripping portion 146 extending from the narrow neck portion, the pair of resilient arms having an inner rounded surface (not shown) adapted to fit over the outer surface of the third dilator tube to connect the second and third dilator tubes. Removing the second locking clip allows the third or outer dilator tube to slidably telescope over the second inner dilator tube to further dilate tissue at the distal end of the dilation introducer.
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As part of the means for removably connecting the second and third dilator tubes together, the third dilator tube includes interior opposing bayonet slots 278 for receiving the pair of opposing bayonet pins of the second or intermediate dilator tube. A tubular bone drill or tap can be inserted through the first or inner dilator tube, and the tubular bone drill or tap can be threaded over a guide wire or K wire to contact the surface of the vertebra or bone to be treated, as described above.
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Facet Screw Surgical Technique:
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An entry point is located on the bone tissue to be treated, and the tip of a guide wire or K-wire 151 is placed at the entry point on the bone tissue to be treated shown in
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The parallel guide insert includes a main cylindrical shaft 425 connected at a proximal end 426 to the cylindrical head of the parallel guide insert. The parallel guide insert includes a plurality of longitudinal bores 428 extending the length of the parallel guide insert from the distal end 430, with distal openings visible in
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The parallel guide insert includes a main cylindrical shaft 465 connected at a proximal end 466 to the cylindrical head of the parallel guide insert. The parallel guide insert includes a plurality of longitudinal bores 468 extending the length of the parallel guide insert from the angled distal end 470, with distal openings visible in
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The second or intermediate dilator tube 526 of the dilation introducer has a distal end (not shown) and a proximal end 530 with a cylindrical head 532. The means for removably connecting the second and third dilator tubes together in a locked configuration includes a second latching member 534, having a shaft 536 and a latching end 538, such as a hook, projecting from the cylindrical head toward the distal end, and connected to a second locking button 540, which extends transversely out through a side aperture 542 in the cylindrical head. The locking button includes a shaft 544 and an enlarged head 546 connected to the shaft, and the locking button is biased outwardly from the cylindrical head by a spring 548. The latching member is received in an upper aperture 550 of the adjacent cylindrical head of a third or second intermediate dilator tube 552, having a side opening latching chamber 554 for retaining the latching end of the latching member when the locking button is biased outwardly by its spring, to lock the cylindrical heads of the second and third dilator tubes together. The cylindrical heads of the second and third dilator tubes can be unlocked and separated by manually depressing the second locking button to move the latching member inwardly and the latching end of the latching member inwardly out of the side opening latching chamber. In all other aspects, the second dilator tube is essentially the same as the second dilator tube of the embodiment of
The third, or second intermediate, dilator tube 552 of the dilation introducer has a distal end (not shown) and a proximal end 556 with a cylindrical head 558. The means for removably connecting the third dilator tube and the outer dilator tube 560 together in a locked configuration includes a third latching member 562, having a shaft 564 and a latching end 566, such as a hook, projecting from the cylindrical head toward the distal end, and connected to a third locking button 568, which extends transversely out through a side aperture 570 in the cylindrical head. The third locking button includes a shaft 572 and an enlarged head 574 connected to the shaft, and the third locking button is biased outwardly from the cylindrical head by a spring 576. The latching member is received in an upper aperture 578 of the adjacent cylindrical head 580 of the outer dilator tube, having a side opening latching chamber 582 for retaining the latching end of the latching member when the locking button is biased outwardly by its spring, to lock the cylindrical heads of the third and outer dilator tubes together. The cylindrical heads of the third and outer dilator tubes can be unlocked and separated by manually depressing the third locking button to move the latching member inwardly and the latching end of the latching member inwardly out of the side opening latching chamber. In all other aspects, the third dilator tube is essentially the same as the second dilator tube of the embodiment of
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A second or outer generally tubular section 646 is slidably disposed over the first or inner generally tubular section, and includes a tubular proximal portion 648 and a distal portion 650 with at least two substantial identical opposing passive spreader flaps 652 interposed between the active spreader arms, hingedly connected to the tubular proximal portion at proximal ends 654, and moveable radially at their distal tips 656. The distal tips of the passive spreader flaps preferably also have beveled edges to deflect soft tissue during insertion of the telescoping expander sleeve. The distal tips of the passive spreader flaps when placed together in an unexpanded configuration have a generally circular configuration, so that the distal tips of two passive spreader flaps, for example, have a semi-circular configuration. The passive spreader flaps taper progressively toward their narrowed proximal ends connected to the tubular proximal portion of the outer tubular section. In a presently preferred aspect, the passive spreader flaps are connected to the tubular proximal portion of the outer generally tubular section by rings 656 passing through apertures 658 and 660 in the adjacent ends of the tubular proximal portion and the passive spreader flaps, respectively.
The active spreader arms are slidably interposed between and engage the passive spreader flaps, so that as the telescoping expander sleeve telescopes from an extended, unexpanded configuration to a collapsed, expanded configuration, as shown in
In the foregoing embodiments, the components of the dilation introducer may be formed from plastic, stainless steel, or similar materials or combinations thereof, that can be readily sterilized and packaged ready for use, after which the dilation introducer may be disposed of or resterilized for subsequent use, as desired. The dilator tubes may be radioluscent, with radiopaque markers located on the tips of one or more of the dilator tubes. The tip of the first dilator may also be scored, grooved, or otherwise be provided with a rough surface, to prevent migration. The dilation introducer may also have curved or otherwise non-linear dilator tubes, and the dilation introducer may also have a non-cylindrical shape, such as an oval shape, for example, to allow the dilation introducer to be inserted around objects or a patient's organs.
It should also be appreciated that one or more devices can be inserted through the same dilation introducer, and that the dilation introducer can be repositioned within the same incision for fixation of multiple devices. In addition, fiber optic devices may be inserted through or integrated with the dilation introducer for visual inspection of the target area. While particular locking features have been described for the different embodiments of the dilation introducer, any combination of locking features or alternate locking features may be utilized. The outer dilator tube may not be locked, and a handle on the outer dilator tube may simply be used as a stop. It should also be appreciated that while the invention has been described as being used in the context of orthopedic surgery, and more particularly for implantation of bone fixation devices, the dilation introducer of the invention can also be useful in dilation of soft tissue for percutaneous, minimally invasive surgical procedures such as nephrostomy, neurosurgery, heart valve repair or replacement, gastrointestinal surgery such as for gall bladder or gall stone surgery, hernia removal, transjugular intrahepatic portal-systemic shunt (TIPS) procedures for treatment of the liver, and the like.
It will be apparent from the foregoing that, while particular forms of the invention have been illustrated and described, various modifications can be made without departing from the spirit and scope of the invention. Accordingly, it is not intended that the invention be limited, except as by the appended claims.
Claims
1. In a dilation introducer for surgery on an internal body structure, the dilation introducer having a locked assembled configuration for initial placement of the dilation introducer against a patient's bone tissue to be treated, and an unlocked, collapsed configuration dilating the patient's soft tissue down to the tissue to be treated to a desired degree of dilation to permit minimally invasive surgical procedures on the patient's tissue to be treated, the improvement in the dilation introducer comprising:
- at least one dilator tube having a distal end and a proximal end, the distal end of the at least one dilator tube including a plurality of spikes.
2. The dilation introducer of claim 1, wherein said spikes are formed of radiopaque material.
3. The dilation introducer of claim 1, wherein said spikes are formed are formed with a rounded shape so as to deflect soft tissue.
4. The dilation introducer of claim 1, further comprising a parallel guide insert adapted to be received in said at least one additional dilator tube, said parallel guide insert including a main cylindrical shaft having a proximal end connected to a cylindrical head, and a plurality of longitudinal bores extending the length of the parallel guide insert through the main cylindrical shaft and cylindrical head, and wherein parallel guide insert has a distal tip with a plurality of spikes.
5. The dilation introducer of claim 4, wherein said spikes are formed of radiopaque material.
6. The dilation introducer of claim 4, wherein said spikes are formed are formed with a rounded shape so as to deflect soft tissue.
7. A dilation introducer for surgery on an internal structure to be treated, the dilation introducer having a locked assembled configuration for initial placement of the dilation introducer against a patient's tissue to be treated, and an unlocked, collapsed configuration dilating the patient's soft tissue down to the tissue to be treated to a desired degree of dilation to permit minimally invasive surgical procedures on the patient's tissue to be treated, comprising:
- a first dilator tube having a distal end with a tapered tip and a proximal end with a cylindrical head;
- a second dilator tube, the first dilator tube being removably received in the second dilator tube for slidable telescoping movement within the second dilator tube, the second dilator tube having a distal end with a tapered tip and a proximal end with a cylindrical head, and an inner lumen with a distal opening and a proximal opening; and
- means for removably connecting the first and second dilator tubes together in a locked configuration including a first latching member disposed in the cylindrical head of the first dilator tube, the first latching member having locking button connected transversely to a shaft with a latching end projecting from the cylindrical head of the first dilator tube toward the distal end of the first dilator tube, the locking button extending transversely from the shaft through a side aperture in the cylindrical head of the first dilator tube, the locking button being biased outwardly from the cylindrical head, the first latching member being received in an upper aperture of the cylindrical head of the second dilator tube, the upper aperture of the cylindrical head of the second dilator tube having a latching chamber for retaining the latching end of the latching member when the locking button is biased outwardly, to lock the cylindrical heads of the first and second dilator tubes together, the locking button being moveable inwardly to move the latching member inwardly and the latching end of the latching member inwardly out of the latching chamber.
8. The dilation introducer of claim 7, further comprising at least one additional dilator tube, the second dilator tube being removably received in the at least one additional dilator tube for slidable telescoping movement within the at least one additional dilator tube, the at least one additional dilator tube having a distal end and a proximal end with a cylindrical head, an inner lumen with a distal opening and a proximal opening, the distal end having a tapered tip, the second dilator tube and the at least one additional dilator tube having an unlocked configuration in which the at least one additional dilator tube is permitted to slidably telescope over the second dilator tube to dilate the patient's soft tissue at the distal end of the dilation introducer; and
- means for removably connecting the second dilator tube and the at least one additional dilator tube together in a locked configuration including a second latching member disposed in the cylindrical head of the second dilator tube, the second latching member having locking button connected transversely to a shaft with a latching end projecting from the cylindrical head of the second dilator tube toward the distal end of the second dilator tube, the locking button extending transversely from the shaft through a side aperture in the cylindrical head of the second dilator tube, the locking button being biased outwardly from the cylindrical head, the second latching member being received in an upper aperture of the cylindrical head of the at least one additional dilator tube, the upper aperture of the cylindrical head of the at least one additional dilator tube having a latching chamber for retaining the latching end of the second latching member when the locking button is biased outwardly, to lock the cylindrical heads of the second and at least one additional dilator tubes together, the locking button being moveable inwardly to move the second latching member inwardly and the latching end of the second latching member inwardly out of the latching chamber.
9. The dilation introducer of claim 8, wherein said at least one additional dilator tube comprises a handle connected to the proximal end of said at least one additional dilator tube, and the cylindrical head of said at least one additional dilator tube including a plurality of said upper apertures each including one said latching chamber for receiving the second latching member.
10. In a dilation introducer for orthopedic surgery, the dilation introducer having a locked assembled configuration for initial placement of the dilation introducer against a patient's tissue to be treated, and an unlocked, collapsed configuration dilating the patient's soft tissue down to the tissue to be treated to a desired degree of dilation to permit minimally invasive surgical procedures on the patient's tissue to be treated, the improvement in the dilation introducer comprising:
- at least one dilator tube having a tubular shaft, a distal end and a proximal end, an inner lumen with a distal opening and a proximal opening; and
- a light emitter disposed in said at least one additional dilator tube.
11. The dilation introducer of claim 10, wherein said light emitter comprises a light emitting diode.
12. The dilation introducer of claim 11, wherein said light emitting diode is embedded in said tubular shaft of said at least one dilator tube.
13. The dilation introducer of claim 10, wherein said light emitter comprises a fiber optic.
14. The dilation introducer of claim 13, wherein said fiber optic is embedded in said tubular shaft of said at least one dilator tube.
15. The dilation introducer of claim 10, wherein said at least one dilator tube comprises a handle and a switch for controlling said light emitter, and at least one battery is disposed in said handle, said at least one battery being connected to said switch to power said light emitter.
16. The dilation introducer of claim 13, wherein said light emitter further comprises a light source providing light conducted to said at least one fiber optic.
17. The dilation introducer of claim 10, wherein said light emitter comprises at least one elongated energy conducting member disposed on an outer surface of the tubular shaft of said at least one dilator tube.
18. The dilation introducer of claim 17, wherein said at least one elongated energy conducting member is disposed in a groove on the exterior surface of the tubular shaft.
19. A telescoping expander sleeve adapted to be slidably disposed over a shaft of a dilator tube for dilating a patient's soft tissue down to tissue to be treated to a desired degree of dilation to permit minimally invasive surgical procedures on the patient's tissue to be treated, the telescoping expander sleeve being moveable between an extended, unexpanded configuration and a collapsed, expanded configuration, the telescoping expander sleeve comprising:
- a first generally tubular section having a tubular proximal portion and a distal portion, the tubular proximal portion having an enlarged proximal head, and the distal portion including at least two active spreader arms each having a proximal end and a distal tip, said at least two active spreader arms being connected at the proximal end, respectively, to the tubular proximal portion, said distal tips of said at least two active spreader arms being moveable radially between an unexpanded configuration and an expanded configuration;
- a second generally tubular section slidably disposed over the first generally tubular section, said second generally tubular section including a tubular proximal portion and a distal portion including at least two passive spreader flaps each having a narrow proximal end and a wide distal tip, said proximal ends of said at least two passive spreader flaps being hingedly connected to said tubular proximal portion, said distal tips of said at least two passive spreader flaps being moveable radially between an unexpanded configuration and an expanded configuration, said at least two active spreader arms slidably engaging said at least two passive spreader flaps, so that as the telescoping expander sleeve telescopes from the extended, unexpanded configuration to a collapsed, expanded configuration, said at least two active spreader arms slide from the narrow proximal ends of said at least two passive spreader flaps to the wider distal ends of the passive spreader flaps to spread the distal ends of said at least two passive spreader flaps apart and to spread the distal ends of said at least two active spreader arms apart.
20. The telescoping expander sleeve of claim 19, wherein the distal tips of said at least two active spreader arms have beveled edges to deflect soft tissue during insertion of the telescoping expander sleeve.
21. The telescoping expander sleeve of claim 19, wherein the distal tips of said at least two passive spreader flaps have beveled edges to deflect soft tissue during insertion of the telescoping expander sleeve.
22. A guide wire assembly for use with a telescoping dilation introducer in treatment of soft tissue, to provide a surface against which the telescoping dilation introducer can be pushed during operation of the telescoping dilation introducer, comprising:
- an elongated tubular section having a proximal end, a distal end, an internal bore, and a frustoconical distal tip with a narrowed portion at the distal end and an enlarged flat shoulder at a proximal portion of the frustoconical distal tip; and
- an elongated generally cylindrical section removably received in said internal bore of said elongated tubular section, the elongated generally cylindrical section having a proximal enlarged head and an elongated body portion, said elongated body portion having a proximal end and a distal end, said distal end having a pointed distal tip, such that when said elongated generally cylindrical section is received in said elongated tubular section, said pointed distal tip extends out of the distal end of said frustoconical distal tip to present a sharp point that can be positioned in soft tissue, and such that when said elongated generally cylindrical section is thereafter removed, said enlarged flat shoulder of said frustoconical distal tip provides a surface against which a telescoping dilation introducer can be pushed for operation of the telescoping dilation introducer in treatment of soft tissue.
23. The guide wire assembly of claim 22, wherein said elongated body portion of said elongated generally cylindrical section includes a proximal section adjacent to said proximal enlarged head and an elongated main section connected to the proximal section, said proximal section having a diameter larger than an outer diameter of said elongated tubular section, and said elongated main section having a diameter narrower than the diameter of said internal bore of said elongated tubular section so as to be receivable in said internal bore of said elongated tubular section, such that when said elongated main section is received in said internal bore of said elongated tubular section and said proximal section of the elongated body portion of the elongated generally cylindrical section is seated against said proximal end of said elongated tubular section, said pointed distal tip extends out of said frustoconical distal tip of said elongated tubular section so that said guide wire assembly presents a pointed distal end.
Type: Application
Filed: Jan 19, 2005
Publication Date: Nov 17, 2005
Inventors: Brad Culbert (Rancho Santa Margarita, CA), Fausto Olmos (Laguna Niguel, CA), Christopher Warren (Aliso Viejo, CA)
Application Number: 11/038,784