摘要:
Apparatus for providing percutaneous access to the human sacral and lumbar vertebrae in alignment with a visualized, trans-sacral axial instrumentation/fusion (TASIF) line in a minimally invasive, low trauma, manner. A number of related TASIF methods and surgical tool sets are provided by the present invention that are employed to form a percutaneous pathway from an anterior or posterior skin incision to a respective anterior or posterior target point of a sacral surface. The percutaneous pathway is generally axially aligned with an anterior axial instrumentation fusion line (AAIFL) or a posterior axial instrumentation/fusion line (PAIFL) extending from the respective anterior or posterior target point through at least one sacral vertebral body and one or more lumbar vertebral body in the cephalad direction and visualized by radiographic or fluoroscopic equipment. The anterior or posterior percutaneous pathway so formed enables introduction of further tools and instruments for boring one or more respective anterior or posterior TASIF bores in the cephalad direction through the one or more vertebral bodies and intervertebral spinal discs, if present. A single anterior or posterior TASIF bores is preferably aligned axially with the respective visualized AAIFL or PAIFL, and plural anterior or posterior TASIF bore are preferably aligned in parallel with the respective visualized AAIFL or PAIFL. Introduction of spinal implants and instruments is enabled by the provision of the percutaneous pathway in accordance with the present invention and formation of the anterior or posterior TASIF bore(s).
摘要:
Surgical apparatus for forming one or more curved axial bore commencing from an anterior or posterior sacral target point and cephalad through vertebral bodies in general alignment with a visualized, trans-sacral axial instrumentation/fusion (TASIF) line in a minimally invasive, low trauma, manner. An anterior axial instrumentation/fusion line (AAIFL) or a posterior axial instrumentation/fusion line (PAIFL) that extends from the anterior or posterior target point, respectively, in the cephalad direction following the spinal curvature through one or more vertebral body is visualized by radiographic or fluoroscopic equipment. Generally curved anterior or posterior TASIF axial bores (22) are formed in axial or parallel or diverging alignment with the visualized AAIFL or PAIFL, respectively. The anterior and posterior TASIF axial bore forming tools (10, 110) can be manipulated from proximal portions thereof to adjust the curvature of the anterior or posterior TASIF axial bores as they are formed in the cephalad direction.
摘要:
Apparatus for a partial or complete discectomy of an intervertebral spinal disc accessed by one or more trans-sacral axial spinal instrumentation/fusion (TASIF) axial bore (22, 152) formed through vertebral bodies in general alignment with a visualized, trans-sacral anterior or posterior axial instrumentation/fusion line (AAIFL or PAIFL) line. A discectomy instrument (130) is introduced through the axial bore, the axial disc opening, and into the nucleus to locate the instrument cutting head (134) within the nucleus of the disc. The cutting head is operated by operating means (140) coupled to the instrument body proximal end for extending the cutting head laterally away from the disc opening. A discectomy sheath (180) is first introduced to extend from the skin incision through the axial bore and into the axial disc opening, the sheath having a lumen for introducing discectomy instruments therethrough and for irrigation and aspiration of the disc cavity.
摘要:
The invention provides an implantable spinal distraction/fusion rod (310) with varied thread pitch (PD, PP) and diameters along different portions of its length that it is capable of distracting two or more vertebral bodies relative to each other and/or facilitating the procedure of fusing the vertebral bodies together from within the spine. In one embodiment, the rod (310) extends between a distal, leading end (312) and a proximal, trailing end (314) and comprises a proximal threaded section (320), a distal threaded section (322), and an intermediate section (336) that can be threaded or unthreaded.
摘要:
Apparatus is employed for forming one or more shaped axial bore extending from an accessed posterior or anterior target point in the cephalad direction through vertebral bodies and intervertebral spinal discs, if present, in general alignment with a visualized, trans-sacral axial instrumentation/fusion (TASIF) line in a minimally invasive, low trama, manner. An anterior axial instrumentation/fusion line (AAIFL) or a posterior axial instrumentation/fusion line (PAIFL) that extends from the anterior or posterior target point, respectively, in the cephalad direction following the spinal curvature through one or more vertebral body is visualized by radiographic or fluoroscopic equipment. Further, bore enlarging tools are employed to enlarge one or more selected section of the anterior or posterior TASIF axial bore(s).
摘要:
Axial implants (58, 102, 300, 400, 500, 600, 700, 800) for fusing and/or stabilizing spinal vertebrae and apparatus for implanting one or more of such axial spinal implants axially within one or more axial bore within vertebral bodies in alignment with a visualized, trans-sacral axial instrumentation/fusion (TASIF) line in a minimally invasive, low trauma, manner. Attachment mechanisms are provided that affix or force the preformed axial spinal implants to or against the vertebral bone along the full length of a TASIF axial bore or bores (22) or pilot holes or at the cephalad end and/or caudal end of the TASIF axial bore or bores or pilot holes. The engagement of the vertebral body is either an active engagement upon implantation of the spinal implant into the TASIF bore or a passive engagement of the external surface configuration with the vertebral bone caused by bone growth about the external surface configuration.