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Systems and methods for delivering an implant between adjacent vertebras using endoscopy

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Systems and methods for delivering an implant between adjacent vertebras using endoscopy


An optical intervertebral implantation system can be used for a method of implanting an intervertebral implant into an intervertebral space with visualization. The system can include an elongate light guide and an intervertebral implant operably coupled with the elongate light guide. The elongate light guide can be configured as a guide wire and received through an aperture of the implant. The elongate light guide can be configured as a guide wire and the implant is received over and slides along on outside surface of the elongate light guide. The elongate light guide can be configured as a cannula having an internal conduit and the implant is received within the conduit. The elongate light guide can be configured as a cannula with an internal conduit and the implant is slidably coupled with an internal surface of the internal conduit of the cannula.

Browse recent Arthrodisc, L.L.C. patents - Park City, UT, US
Inventor: Richard I. Zipnick
USPTO Applicaton #: #20120330425 - Class: 623 1716 (USPTO) - 12/27/12 - Class 623 
Prosthesis (i.e., Artificial Body Members), Parts Thereof, Or Aids And Accessories Therefor > Implantable Prosthesis >Bone >Spine Bone >Including Spinal Disc Spacer Between Adjacent Spine Bones

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The Patent Description & Claims data below is from USPTO Patent Application 20120330425, Systems and methods for delivering an implant between adjacent vertebras using endoscopy.

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CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation-in-part of U.S. patent application Ser. No. 13/370,925 filed Feb. 10, 2012 and continuation-in-part of U.S. patent application Ser. No. 13/478,870 filed May 23, 2012, which are continuation-in-parts of U.S. patent application Ser. No. 13/199,324 filed Aug. 26, 2011 [P12], which is a continuation-in-part of U.S. patent application Ser. No. 13/065,291, filed Mar. 18, 2011 [P11], which patent applications are incorporated herein by specific reference in their entirety.

BACKGROUND

An intervertebral disc is a soft tissue compartment connecting the vertebra bones in a spinal column. Each healthy disc consists of two parts, an outer annulus fibrosis (hereinafter “the annulus”) and an inner nucleus pulposes (hereinafter “the nucleus”). The annulus completely circumscribes and encloses the nucleus. The annulus is connected to its adjacent associated pair of vertebrae by collagen fibers. The intervertebral disc is an example of a soft tissue compartment adjoining first and second bones (vertebra) having an initial height and an initial width. Other joints consisting of a soft tissue compartment adjoining at least first and second bones having an initial height and an initial width include the joints of the hand, wrist, elbow, shoulder, foot, ankle, knee, hip, and the like.

Typically, when a disc is damaged, the annulus ruptures and the nucleus herniates. Discectomy surgery removes the extruded nucleus, leaving behind the ruptured annulus. The ruptured annulus is, by itself, ineffective in controlling motion and supporting the loads applied by the adjacent pair of vertebrae. With time, the disc flattens, widens, and bulges, compressing nerves and producing pain. Uncontrolled loads are transmitted to each vertebra. Each vertebra tends to grow wider in an attempt to distribute and compensate for higher loads. When a vertebra grows, bone spurs form. The bone spurs further compress nerves, producing pain. In response to damaged discs, especially herniated disks, a variety of intervertebral devices are disclosed in the art to replace the intervertebral disc. Such devices are implanted intermediate an adjacent pair of vertebra, and function to assist the vertebra. These devices do not assist the intervertebral disc. In fact, in many cases the disc is removed. Insertion of these devices has heretofore been complicated, problematic, and usually performed blindly or with only fluoroscopy or other radioimaging techniques.

In one embodiment, a system of the present invention can include a cannula, which may be an elongate light guide having an implant in a lumen therein, or may be configured to receive an elongated light guide having an implant thereon. The cannula can include a distal end with a pointed, canted end configured to push a nerve laterally with respect to the cannula when the pointed, canted distal end contacts the nerve and the cannula is rotated. That is, the distal end can have a sloped surface that extends from a tip to a more proximal portion, where the sloped surface extends from one side of the cannula to the other side of the cannula, such as shown in FIGS. 232-235 and 235F-235I. Accordingly, the distal end of the cannula includes an asymmetrical end or point from one side to the other, and the distal end can also be blunt or flat and inserted on an angle.

In one embodiment, a method of implanting an intervertebral implant can use the cannula having the pointed, canted distal end. In one aspect, this cannula and/or implant can be used to pass by a nerve without severing or injuring the nerve. The pointed end can be passed by the nerve so that the sloped surface of the pointed, canted end contacts the nerve. In one aspect, the sloped surface can be pushed past the nerve so that the nerve moves laterally and onto a side surface of the cannula and/or implant, where the side surface of the cannula and/or implant can be a longitudinally extending surface that extends between a distal and a proximal end. In another aspect, the nerve can be moved laterally around the distal end of the cannula and/or implant by contacting the sloped surface of the pointed, canted distal end of the cannula and/or implant with a nerve; and rotating the pointed, canted distal end of the cannula and/or implant so as to push the nerve laterally with respect to the cannula and/or implant until the nerve no longer contacts a side surface of the cannula. That is, the rotation of the cannula moves the nerve laterally from the sloped surface to the side surface of the cannula and/or implant, such as the side surface of the cannula and/or implant has a longitudinally extending surface that extends between a distal and a proximal end.

In view of the foregoing, it would be advantageous to have implantation devices, systems, and methods that allow for visualization of the disc as well as the implantation of a medical device between adjacent vertebra using endoscopy.

SUMMARY

In one embodiment, an optical intravertebral implantation system can include: an elongate light guide; and an intravertebral implant slideably coupled with the elongate light guide. The elongate light guide can be configured as a guide wire and received through an aperture of the implant. The elongate light guide can be configured as a guide wire and the implant is received over and slides along on outside surface of the elongate light guide. The elongate light guide can be configured as a cannula having an internal conduit and the implant is received within the conduit. The elongate light guide can be configured as a cannula with an internal conduit and the implant is slidably coupled with an internal surface of the internal conduit of the cannula.

The system can have various configurations, such as: the elongate light guide is bendable or rigid; the elongate light guide can be operably coupled to a image sensor; the elongate light guide can be operably coupled with a monitor; the elongate light guide can be coupled to one or more imaging focusing elements.

In one embodiment, the system can include a coloring agent.

In one embodiment, an implant delivery device, such as a push member or the like can be coupled with the implant and the implant delivery device is slidably coupled with the elongate light guide.

In one embodiment, the elongate light guide includes a first optical fiber operably coupled with a light source and a second optical fiber coupled to an image sensor. Additional optical fibers may be used.

In one embodiment, the implant is not rotatable with respect to the elongate light guide.

In one embodiment, the elongate light guide can be configured as a guide wire and the implant is received over and slides along on outside surface of the elongate light guide, and can also include a cannula having an internal conduit adapted to receive the implant and elongate light guide therethrough.

In one embodiment, the elongate light guide can be configured as a cannula with an internal conduit and the implant is slidably coupled with an internal surface of the internal conduit of the cannula, and can also include a guide wire slidably received through an aperture of the implant.

In one embodiment, a method of implanting an intravertebral implant with visualization can include: obtaining the implant system having an elongate light guide with an intravertebral implant slidably coupled therewith; inserting the elongate light guide into an intravertebral space; sliding the intravertebral implant along the elongate light guide, the implant being slideably coupled with the elongate light guide; implanting the implant in the intravertebral space after sliding the implant off of the elongate light guide; and visualizing the implant in the intravertebral space with the elongate light guide.

In one embodiment, the method can also include: obtaining the elongate light guide configured as a guide wire; inserting the elongate light guide through an aperture of the implant; and pushing the implant off of a distal end of the elongate light guide.

In one embodiment, the method can also include obtaining the elongate light guide configured as a guide wire; operably coupling the implant with the elongate light guide such that the implant is received over and slides along on outside surface of the elongate light guide; and pushing the implant off of a distal end of the elongate light guide.

In one embodiment, the method can also include: obtaining the elongate light guide configured as a cannula having an internal conduit; operably coupling the implant with the cannula so as to be received within the conduit; and pushing the implant out of the conduit.

In one embodiment, the method can also include: obtaining the elongate light guide configured as a cannula with an internal conduit; operably coupling the implant with the cannula so as to be slidably coupled with an internal surface of the internal conduit of the cannula; and pushing the implant out of the conduit.

In one embodiment, the method can also include: operably coupling the elongate light guide a image sensor; and viewing the implantation of the implant into the intravertebral space.

In one embodiment, the method can also include: creating internal traction within a disc between adjacent vertebras with the implant by implantation such that the adjacent vertebras are separated from an initial distance apart to a longer distance apart by the implant; and visualizing the internal traction.

In one embodiment, the method can also include: injecting a coloring agent into the intravertabral space; and visually distinguishing between healthy tissue portions and damaged tissue portions with the coloring agent.

In one embodiment, the method can also include: injecting a coloring agent into the intravertabral space; and visually distinguishing between a first tissue type and a second tissue type with the coloring agent.

In one embodiment, the method can also include: obtaining the implant so as to be coupled to an implant delivery device; sliding the implant along the elongate light guide with the implant delivery device; and uncoupling the implant from the implant delivery device for implantation of the implant into the intravertebral space.

In one embodiment, the method can also include: obtaining the elongate light guide to include a first optical fiber operably coupled with a light source and a second optical fiber coupled to an image sensor; and observing an image of the implant in the intravertebral space on a monitor, the image being provided to the monitor from the image sensor.

In one embodiment, the method can also include: rotating the elongate light guide so as to correspondingly rotate the implant.

The foregoing summary is illustrative only and is not intended to be in any way limiting. In addition to the illustrative aspects, embodiments, and features described above, further aspects, embodiments, and features will become apparent by reference to the drawings and the following detailed description.

BRIEF DESCRIPTION OF THE FIGURES

The foregoing and following information as well as other features of this disclosure will become more fully apparent from the following description and appended claims, taken in conjunction with the accompanying drawings. Understanding that these drawings depict only several embodiments in accordance with the disclosure and are, therefore, not to be considered limiting of its scope, the disclosure will be described with additional specificity and detail through use of the accompanying drawings, in which:

FIG. 1 is a perspective view illustrating an intervertebral device constructed in accordance with the principles of the invention;

FIG. 1A is a perspective view of a tool that can be utilized in the practice of the invention;

FIG. 2 is a perspective—partial section view of the device of FIG. 1 illustrating additional construction details thereof;

FIG. 3 is an exploded view of certain components of the device of FIG. 1:

FIG. 4 is a perspective view further illustrating the device of FIG. 1;

FIG. 5 is a perspective view of the device of FIG. 1 illustrating certain components in ghost outline;

FIG. 6 is a top view illustrating the insertion of the device of FIG. 1 in an intervertebral disc adjacent the spinal column;

FIG. 7 is a side elevation view further illustrating the insertion of the device of FIG. 1 in the spinal column;

FIG. 8 is a top view illustrating a damaged intervertebral disc with a portion thereof bulging and pressing against the spinal column;

FIG. 9 is a top view illustrating the disc of FIG. 8 manipulated with a device constructed in accordance with the invention to alter the shape and dimension of the disc to revitalize the disc and take pressure off the spinal column;

FIG. 10 is a top view illustrating the disc of FIG. 8 manipulated with an alternate device constructed in accordance with the invention to alter the shape and dimension of the disc to revitalize the disc and take pressure off the spinal column;

FIG. 11 is a top view illustrating the disc of FIG. 8 manipulated in accordance with the invention to alter the shape of the disc from a normal “C-shape” to an oval shape;

FIG. 12 is a side elevation view illustrating a bulging disc intermediate a pair of vertebrae;

FIG. 13 is a side elevation view illustrating the disc and vertebrae of FIG. 12 after internal traction;

FIG. 14 is a side elevation view illustrating a rubber band or string that has a bulge similar to the bulge formed in a intervertebral disc;

FIG. 15 is a side elevation view illustrating the rubber band of FIG. 14 after it has been tensioned to remove the bulge;

FIG. 16 is a perspective view illustrating a spring apparatus in accordance with an alternate embodiment of the invention;

FIG. 17 is a front elevation view illustrating the embodiment of the invention of FIG. 16;

FIG. 18 is a perspective view illustrating an insertion member utilized to implant the spring apparatus of FIG. 16 in a spinal disc;

FIG. 19 is a top view illustrating the insertion member of FIG. 18 after the spring apparatus is implanted in a spinal disc;

FIG. 20 is a top view of a portion of a spinal column illustrating the spring of FIG. 16 inserted in a disc;



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stats Patent Info
Application #
US 20120330425 A1
Publish Date
12/27/2012
Document #
13605752
File Date
09/06/2012
USPTO Class
623 1716
Other USPTO Classes
International Class
61F2/44
Drawings
117



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