The present invention relates generally to the field of surgery and medical implants, and more particularly, to surgical tools and methods for positioning an intervertebral device between vertebral members of a patient.
The human spine is a biomechanical structure with thirty-three vertebral members, and is responsible for protecting the spinal cord, nerve roots and internal organs of the thorax and abdomen. The spine also provides structure support for the body while permitting flexibility of motion. A significant portion of the population will experience back pain at some point in their lives resulting from a spinal condition. The pain may range from general discomfort to disabling pain that immobilizes the individual. Back pain may result from a trauma to the spine, be caused by the natural aging process, or may be the result of a degenerative disease or condition.
Procedures to remedy back problems sometimes require correcting the distance between vertebral members by inserting an intervertebral device or spacer between the members. The spacer, which is carefully positioned within the disc space and aligned relative to the vertebral members, is sized to position the vertebral members in a manner to alleviate the patient's back pain.
The intervertebral device may be designed to facilitate insertion into the body. The shape and size of the device are selected to minimize intrusion to a patient during insertion, but still be effective post-insertion to alleviate the pain and provide maximum mobility to the patient.
The present invention comprises an insertion tool and method for facilitating positioning an intervertebral device (e.g., a spacer) within a patient. The tools and methods disclosed herein employ tool-to-device attachment approaches that are of sufficient strength for the insertion tool to be readily utilized to accurately insert and place the device (as well as extract the device when necessary). Further, after insertion, the attachment approaches presented provide for detachment and removal of the insertion tool while the intervertebral device remains within the body, and do not deter from the functionality of the device once within the body.
More particularly, in one aspect, presented herein is a surgical tool for inserting/extracting an intervertebral device. The surgical tool includes an insertion/extraction mechanism including an elongate inserter and an engagement mechanism. The elongate inserter has proximal and distal ends, with the engagement mechanism being disposed at the distal end of the elongate inserter. The engagement mechanism includes an engagement surface configured to at least partially conform to the intervertebral device. The engagement mechanism is adapted to releasably engage the intervertebral device employing a vacuum coupling or a magnetic coupling between the engagement mechanism and the intervertebral device.
In another aspect, a surgical tool is provided for inserting/extracting an intervertebral device. The surgical tool includes an insertion/extraction mechanism comprising an elongate inserter and an engagement mechanism. The elongate inserter has proximal and distal ends, with the engagement mechanism being disposed at the distal end of the elongate inserter. The engagement mechanism includes an engagement surface configured to at least partially conform to an intervertebral device. The surgical tool further includes a controller for controlling application of a coupling force between the engagement mechanism and the intervertebral device to releasably engage the intervertebral device when disposed adjacent to the engagement surface for facilitating inserting of the intervertebral device between vertebral members of a patient or extracting of the intervertebral device from between vertebral members of a patient.
In a further aspect, a method of positioning an intervertebral device between vertebral members of a patient is provided. The method includes employing a surgical tool having: an insertion/extraction mechanism comprising an elongate inserter and an engagement mechanism, the elongate inserter having proximal and distal ends, and the engagement mechanism being disposed at the distal end of the elongate inserter, wherein the engagement mechanism includes an engagement surface configured to at least partially conform to an intervertebral device; and wherein the engagement mechanism is adapted to releasably engage the intervertebral device employing a vacuum coupling or a magnetic coupling. The employing of the surgical tool includes: employing the engagement mechanism at the distal end of the elongate inserter to releasably engage an intervertebral device using one of the vacuum coupling or magnetic coupling; inserting the intervertebral device between vertebral members of a patient employing the surgical tool; and detaching the intervertebral device from the engagement mechanism by disengaging the one of the vacuum coupling or magnetic coupling therebetween.
In a still further aspect, a method of withdrawing an intervertebral device from between vertebral members of a patient is provided. The method includes employing a surgical tool having: an insertion/extraction mechanism comprising an elongate inserter and an engagement mechanism, the elongate inserter having proximal and distal ends, and the engagement mechanism being disposed at the distal end of the elongate inserter, wherein the engagement mechanism includes an engagement surface configured to at least partially conform to an intervertebral device; and wherein the engagement mechanism is adapted to releasably engage the intervertebral device employing a vacuum coupling or a magnetic coupling. The employing of the surgical tool includes: inserting the engagement mechanism of the surgical tool into the patient to physically contact the intervertebral device; controllably activating the engagement mechanism to releasably engage the intervertebral device using one of vacuum coupling or magnetic coupling; and withdrawing the engagement mechanism and the intervertebral device from the patient and, thereafter, detaching the intervertebral device from the engagement mechanism by disengaging the vacuum coupling or magnetic coupling therebetween.
Further, additional features and advantages are realized through the techniques of the present invention. Other embodiments and aspects of the invention are described in detail herein and are considered a part of the claimed invention.
The subject matter which is regarded as the invention is particularly pointed out and distinctly claimed in the claims at the conclusion of the specification. The foregoing and other objects, features, and advantages of the invention are apparent from the following detailed description taken in conjunction with the accompanying drawings in which:
Generally stated, disclosed herein are various surgical inserter tools and methods for facilitating positioning of an intervertebral device in the intervertebral space between vertebral members of a patient. By way of example, the intervertebral device may be a spacer having any one of various oblong, spherical, curved non-spherical, etc. shapes. One non-spherical-shaped embodiment of a spacer is disclosed in the above-incorporated patent application entitled “Non-Circular Stabilization Sphere and Method”.
Those skilled in the art will note that the term “vertebral member” is used generally herein to describe the vertebral geometry comprising the vertebral body, pedicles, lamina, and processes. Likewise, the term “intervertebral space” is used generally to describe the space between vertebral members. The intervertebral space may be formed between adjacent vertebral members, or between non-adjacent vertebral members. The intervertebral device (e.g., spacer 100) may be sized and shaped, and have adequate strength requirements to be used within the different regions of the spine. Although the intervertebral device illustrated and described above is particularly useful in treating the lumbar region of the spine, it should nevertheless be understood that the device is also applicable to other portions of the spine, including the cervical, thoracic, and sacro-iliac regions.
The term “intervertebral device” (e.g., spacer 100) is used herein in a general sense to describe a device that is positioned between vertebral members. In one embodiment, the device is an implant that remains within the body. In another embodiment, the device is a jib which is a fixture or device to guide or hold a cutting, measuring, or space maintaining device in order to prepare a location, such as a vertebral member or intervertebral space, in order to receive an implant. In these embodiments, the device may be removed from the body at the completion of the procedure. By way of example, the intervertebral device may be solid, or have a hollow interior, or even comprise a mesh structure (i.e., when the surgical tool embodiments employing magnetic coupling are utilized).
The terms “upper”, “lower”, “inner”, “outer”, and the like are terms to describe the relative positioning of different elements, and are used in a general sense. The surgical tool and method embodiments described herein are considered in all respects as illustrative and not restrictive, and all changes coming within the meaning and equivalency range of the appended claims are intended to be embraced therein. Although described hereinbelow principally with reference to inserting an intervertebral device in the intervertebral space between vertebral members of a patient, the surgical tools described could alternatively be employed in extracting an intervertebral device from the intervertebral space between vertebral members.
Various surgical inserter tool embodiments employing vacuum coupling are first described below with reference to
As shown in
In this example, vacuum coupling is provided by a vacuum controller (e.g., vacuum source) 260 in communication with vacuum chamber 212. By way of example, vacuum controller 260 could comprise any conventional vacuum source, including a vacuum pump, vacuum line, suction device, suction bulb, etc. Also coupled to the vacuum chamber is a release valve 270 and a vacuum meter/gage 280.
By way of example, one surgical process embodiment employing surgical inserter tool 200 includes: bringing engagement mechanism 220 in physical contact with intervertebral device 100; actuating vacuum controller 260 to initiate vacuum coupling between the engagement mechanism and the intervertebral device (note that vacuum coupling assumes that the engagement mechanism couples to a solid exterior surface portion of the intervertebral device); inserting the intervertebral device in a pre-prepared intervertebral space between vertebral members of a patient; adjusting and finalizing position of the intervertebral device in the intervertebral space; opening release valve 270 to disengage the vacuum coupling between engagement mechanism 220 and the intervertebral device 100; and thereafter, withdrawing the surgical inserter tool.
With both the tool embodiment of
Referring to
In the embodiment of
Those skilled in the art will note from the above description that various aspects of the surgical inserter tool embodiments described above in connection with
In the tool embodiment of
As a further alternative, a permanent magnetic coupling could be employed by a surgical inserter tool 700 such as shown in
In one embodiment, elongate inserter 710 is a sleeve movably mounted to a pusher shaft 770. In this embodiment, pusher shaft 770 includes a non-magnetic pusher element 800 having a pusher surface 822 at one end, and a handle 775 at an opposite end. The inserter 710 reciprocates between an extended position (shown in
As a further variation, one or more permanent magnetic couplings could be employed in a surgical inserter tool wherein the permanent magnets are disposed on a distal end of a shaft, movably mounted relative to an elongate inserter. In such an embodiment, the permanent magnet(s) can be pushed forward to be even with an engagement surface of the engagement mechanism, and thereby engage the intervertebral device, or retracted from the engagement mechanism and surface, to thereby disengage the intervertebral device from magnetic coupling with the permanent magnet(s). In this embodiment, the engagement surface is a compliant surface that remains substantially stationary and contacts the intervertebral device while engaging or disengaging the magnetic coupling is accomplished using the permanent magnet(s) on the distal end of the shaft. This alternative surgical tool configuration could alternatively be employed with electromagnetic conductors on the distal end of the shaft for active electrical control of the magnetic coupling between the surgical tool and the intervertebral device (as in the embodiment of
By way of further example, any one of the above-described surgical inserter tools could be employed to position an intervertebral device in the intervertebral space between vertebral members of a patient. The surgical method includes employing a surgical tool having: an insertion/extraction mechanism including an elongate inserter and an engagement mechanism, the elongate inserter having proximal and distal ends, with the engagement mechanism being disposed at the distal end of the elongate inserter, and wherein the engagement mechanism includes an engagement surface configured to at least partially conform to an intervertebral device; and wherein the engagement mechanism is adapted to releasably engage the intervertebral device employing a vacuum coupling or a magnetic coupling between the engagement mechanism and the intervertebral device.
Employing of the surgical tool includes: employing the engagement mechanism at the distal end of the elongate inserter to releasably engage the intervertebral device using either vacuum coupling or magnetic coupling; inserting the intervertebral device between vertebral members of a patient employing the surgical tool; and detaching the intervertebral device from the engagement mechanism by disengaging the employed vacuum coupling or magnetic coupling therebtween.
As a still further example, any one of the above-described surgical inserter tools could also be employed to withdraw an intervertebral device from the intervertebral space between vertebral members of a patient. In such a case, employing of such a tool includes: inserting the engagement mechanism of the surgical tool into the patient to physically contact the intervertebral device; controllably activating the engagement mechanism to releasably engage the intervertebral device using one of vacuum coupling or magnetic coupling; and withdrawing the engagement mechanism and intervertebral device from the patient and, thereafter, detaching the intervertebral device from the engagement mechanism by disengaging the vacuum coupling or magnetic coupling therebetween.
Although preferred embodiments have been depicted and described in detail herein, it will be apparent to those skilled in the relevant art that various modifications, additions, substitutions and the like can be made without departing from the spirit of the invention and these are therefore considered to be within the scope of the invention as defined in the following claims.
This application contains subject matter which is related to the subject matter of the following application, which is assigned to the same assignee as this application and which is hereby incorporated herein by reference in its entirety: “Non-Circular Stabilization Sphere and Method”, Allard et al., Ser. No. 11/098,167, filed Apr. 4, 2005 (Attorney Docket No.: P21521.00).